FAQ: Ryan’s Residency Pursuits

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Ryan and I receive many questions about his residency application process, and we thought it would be helpful to consolidate some of the most frequently asked questions so people can reference them moving forward. Okay, it is mostly our parents and family that seem to come back to the same questions repeatedly, but maybe this can help others understand this complex process, too. Because it is more complex than simply applying, interviewing, and signing a contract. So don’t feel bad if you cannot keep all of it straight the first time through, but also keep this handy the next time you get confused.

What is medical residency?

Residency is graduate medical training following completion from medical school for physicians. Residencies range from three to five years in length, depending on the specialty, and some specialties require subsequent years of fellowship training. Residents are minimally paid because they are not yet fully licensed physicians and are still under supervision of attending physicians. Because doctors are huge fans of acronyms and abbreviations, they have designated each year of residency as a PostGraduate Year (PGY). Therefore, doctors in their first year of residency are referred to as PGY-1’s, doctors in their second year of residency as PGY-2’s, and so on (this is relevant later). Also, the name of the shared application system for residents is deemed the Electronic Residency Application Service or ERAS.

What residency is Ryan pursuing and why?

Ryan is pursuing radiation oncology because it offers a magical blend of his previous MRI research, engineering education, and desire for quality time with patients. My favorite description Ryan made to describe radiation oncology to non-medical folk is that it is zapping cancer with lasers. The specialty is much more complex, and we can go into details about that some other time.

How many years of residency are required for radiation oncology?

Five years.

What is the process for applying to residency?

The process for applying to residency actually begins after the second year of medical school when students study for and take the USMLE Step 1 exam. This standardized exam is an important indicator of specialties that a student can or should apply to since some specialties have different suggested score requirements.

Starting in the summer after the third year of medical school, students begin compiling letters of recommendation, writing a personal statement, and completing the common residency application in ERAS. Through ERAS, students can select the programs they want to apply to and monitor interview invites. The applications are submitted in mid-September. Some time in the fall, students also take the USMLE Step 2 exam, which is more clinically focused than Step 1. While this score is typically less pertinent to residency applications, students should do as well or better than the score they received on Step 1.

Radiation oncology is one of a few specialties that has a separate first-year (PGY-1) requirement. This means that students pursuing this specialty must apply to a series of one-year programs in medicine, surgery, or what is called a transition year (TY) in addition to applying to radiation oncology programs.

As soon as the applications are submitted, students are technically able to receive interview invites. Specialties vary in how quickly they send out interview invites and when the interviews are scheduled, but most specialty interviews take place in December and January. After interviewing, students and programs must rank each other, with students submitting their rankings by mid-February. On Match Day in mid-March, students learn where they matched for residency.

Wait, Ryan has to apply to two types of residencies? 

Yes, Ryan must complete an internship year prior to beginning his residency in radiation oncology, meaning his first year in radiation oncology residency will actually be when he is a PGY-2. Ryan will most likely be at a separate institution, potentially in a completely different area of the country, for his first year of residency than his subsequent four years of residency in radiation oncology. There is only a small number of residency programs in radiation oncology that have an attached intern year at the same institution.

Of the one-year programs Ryan applies to, he can choose between a preliminary year in medicine or surgery, working alongside internal medicine or surgery residents, or a transition year program that is basically a toned down version of a preliminary medicine year with stereotypically less strenuous workdays and more flexibility for electives. The applications and interviews for PGY-1 programs do not impact his applications and interviews for radiation oncology.

How many programs does Ryan apply to and interview with?

Ryan applied to around 60 radiation oncology programs and about 15 PGY-1 programs. Ryan will likely interview with 7-10 radiation oncology programs and 5-10 PGY-1 programs.

Where is Ryan applying to residency programs?

For his intern year, Ryan applied to several first-year programs within the Chicago area to increase the chance that I have at least one more year at my job with a more stable income. However, some of the radiation oncology programs he applied to do have a built in intern year at their institution, which may require us to move sooner rather than later.

Ryan applied all over the country for radiation oncology residency. Because radiation oncology is a more competitive specialty with fewer residency spots available, students are encouraged to avoid limiting themselves to one area.

How does Ryan know which residency he secures?

After submitting his residency rankings in February, Ryan must wait until the middle of March to learn of his fate. All fourth year medical students find out at exactly the same time on the exact same Friday where they have matched for residency. They find out the Monday before if they have matched at all. The reveal of which residency students match to is called Match Day, and I already wrote a significant amount about it here that you can refer to as a refresher, if needed.


Well, that’s all for now. For those of you paying attention, we will be getting married between the time Ryan submits his residency rankings and Match Day. Hopefully it helps to know that we will be committed to each other no matter where we end up. If you have any other questions, just let us know!

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One comment on “FAQ: Ryan’s Residency Pursuits
  1. Sherry Emerson says:

    That is an excellent summary of where Ryan currently is and where he is heading. It is quite a lot to comprehend. God bless you both for living through it.

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