Anesthesiology Residency Application Process

You’ve made the decision to pursue anesthesiology. Great! So… now what? What should you be doing? What are the pitfalls for applicants? Having gone through the process, here are some basic things to consider.

BEFORE APPLYING

  • Consider your timeline: Electronic Residency Application Service (ERAS) opens in mid-September, interviews from October to February, rank order list (ROL) opens in mid-January with the deadline in mid-February, Match Day in mid-March.
  • Meet with someone in the anesthesiology department (program director, mentor, etc.) to discuss your goals.
  • Become a medical student member of the American Society of Anesthesiologists (ASA). Attend conferences if you can.
  • Have an updated CV at all times. While it will help tremendously on ERAS, it also comes in handy when applying for research positions.
  • Decide which programs you’re interested in. Categorical and/or advanced? Urban or rural? FREIDA Online is one of the absolute best resources to use when researching programs in any speciality.
  • Register for anesthesiology electives (at least two months worth) and have your grades back prior to beginning interviews. These were the most discussed rotations in my interviews. While the topic of away rotations is important for orthopedic surgery, neurosurgery, dermatology, etc… it’s not an implicit requirement for anesthesiology.
  • If possible, try to get ACLS/BLS certification prior to mid-September. There’s a place to indicate if you’re certified on ERAS, and you’re going to need certification for residency anyways.
  • It’s never too early to start writing your personal statement. Needless to say… edit, re-edit, and then edit the thing all over again. Ask friends and faculty for their opinions – “Does this personal statement convey who I am?”
  • Register for Step 2 CS and get it out of the way ASAP. If you have some time off prior to ERAS opening, knock out Step 2 CK as well. I took mine in September. If you had a not-so-ideal Step 1 score, take Step 2 CK before applying!
  • Gathering letters of recommendation (LORs) was perhaps the most difficult part of the application process as two of my letter-writers were off-service or vacationing in the time leading up to ERAS opening. You’ll need at least three letters. One of these should be from your anesthesiology program director. I had three from anesthesiologists and one from a pediatrician. Decide who will write them, and start asking well in advance!

INTERVIEWS

My interview season spanned from late October to mid-January (plan your MS4 rotations accordingly). At each program, I had 3 to 7 interviews (anywhere from 5 minutes to 25 minutes a piece) which were all incredibly laid back. Sometimes a little too laid back with topics like iOS vs. Android, the shortcomings of Java, McLaren vs. Ferrari’s racing heritage, etc. These were great conversations! 😀

residency-interview-handouts
Handouts from some of my interviews

Before the interview day, visit the program’s website to learn about what’s going on in the department. Also, read over your application as interview questions often stem from things you’ve written. Some topics which seemed to always come up:

  • What aspects do you NOT like about anesthesiology?
  • Anesthesiology often times lacks continuity of patient care. How do you feel about that?
  • If anesthesiology didn’t exist, what residency would you pursue?
  • Tell me about a case you found interesting.
  • Tell me about your hobbies.
  • Interested in pursuing a fellowship? Academics or private practice? Rural or urban?
  • If you see an attending or colleague behaving unprofessionally (ie, self-administering fentanyl), how do you respond?

In general, convey how “trainable” you are. There’s an incredibly steep learning curve once you start anesthesia cases, so programs are looking for residents who can manage this.

Most importantly, take notes after each interview day! What did you like/not like about the program? What “vibes” did you get from your experience there? Often times, these gut instincts are underrated but play a pivotal role in determining where you’ll be happy.


RANK LIST

My only advice: don’t over think it! The match process favors the applicant, so take advantage of that! Rank programs you’ll be happy at because you could theoretically match to any of them. With that said, don’t rank only your very top choices either; you’ll risk not matching anywhere. I’ve heard ranking at least 7 programs is “safe.”

Once the ROL web page goes live in mid-January, applicants can modify and re-certify the list as many times as they want prior to the deadline in mid-February. Refer back to your post-interview notes for guidance. Additionally, unless there’s a very good reason for modification, don’t continuously adjust items on your list – your gut instinct helped generate the first list. There’s a reason for that. 🙂


SUMMARY

If you’ve adequately prepared for the residency application process, it’s actually a lot of fun! Meeting other anesthesiology applicants only reaffirmed my notion that this field is full of happy, laid back, and incredibly bright individuals! Interviews are like mini-vacations to different parts of the country too. 🙂

Best of luck to everyone! Please let me know if you have any questions in the comments section below.

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8 COMMENTS

  1. Hi Dr Kumar! Thank very much for creating this space and for being so open to helping others who -like me- have lots of doubts regarding the process of admission to the residency in the U.S. I’m a Colombian physician very interested in becoming a resident in anesthesia, I’ve already taken and approved Step 1 and Step 2 CS and CK. I plan to participate in the Match 2016. As an IMG, I’m worried about my chances of being admitted and I’m trying to find ways to boost my CV. I’ve been given to understand that getting enrolled in a research program in the U.S. is a good way to do it. Obviously from the financial stand point it’s not so easy for me but if it’s important I’m willing to do it. Also, there’s the fact that isn’t so easy to become part of this projects. How important would think it is to attempt to enroll in a research program? If I only participate in the Match with my scores (Step 1: 225, Step 2 CK: 226, Step 2 CS approved on first attempt), my CV, 3 good LoRs, what do you think are my chances of being admitted? What other advices would you give to improve my chances of being admitted?

    Thank you very much for the help you can give me!

    • Hey Nicolas,

      I’m sure you’re already aware that it’s more difficult for IMGs to apply to a residency in the US, regardless of which field you’re going into. Compared to fields like orthopedics and dermatology, anesthesiology doesn’t have an implicit requirement for research. Also, as you mentioned, it’s difficult to find projects to jump aboard for a short period of time. Your scores are pretty good, so my best advice is to apply and interview broadly, so you have more places you can rank to improve your chances of matching.

      Thanks for the comment!

      • Thank you very much for taking your time to answer, Dr Kumar, you’re very kind! ???? Your advise is very valuable for me. So my idea is to keep trying to enroll in a research program, but even if I can’t do it, I’ll apply anyway with what I got.

        I read your post regarding the difference between preliminary, transitional and advanced positions, however there are still a couple of things I don’t understand and I was wondering I f you could help me to clarify that:

        -What would be the appropriate kind of internship for anesthesia: preliminary? Transitional? Either one?
        -What would be the appropriate proportion of “internship programs” Vs categorical programs that it would be advisable to apply to?
        -FREIDA provides only partial info regarding the type of programs that are participating: of the approx 120 programs participating in the upcoming Match, approx 60 state that they offer preliminary positions, the remaining programs say that they don’t offer preliminary positions, does that mean that they’re categorical?

        Thank you very much for your generous help! ????

        • Focus more on “categorical programs” (where the internship and anesthesia residency are built into one program) and “advanced programs” (where you need to apply separately for a preliminary internship or transitional internship). Preliminary internships are usually in medicine or surgery (you can do either, I’d recommend medicine), and transitional years are a variety of different rotations.

          If a program doesn’t offer a preliminary position, it’s probably advanced and you have to find your own internship.

          I only applied to categorical programs so I’d do my entire residency (internship + anesthesiology) at the same place. 🙂

          • Thanks for your help, Dr Kumar. I’ve been checking the entire list of Anesthesia programs in FREIDA and of the approx 113 programs that I’d be elegible to apply to there are about 45 that state they’re not accepting applications for 2016/2017 period but they’re accepting for 2017/2018. What does this exactly mean? Are those advanced programs for which I have to look for an internship year? Or they are just not participating in this Match? Thank you very much!

          • “Are those advanced programs for which I have to look for an internship year?”

            Yep, I think that’s exactly what it means man! Keep this in mind when you apply to those programs.

  2. Hey Rishi, this is a very well-written, useful post! I just wish I knew where to find pages like this for other residencies. “The steps for success!” (Do you know where to look for them, or is there a database for them like FRIEDA?)

    Ack. As a MS-1 I’ve ruled out /some/ specialties but there are definitely still a lot I haven’t tried or even thought about. We’ll see how this plays out!

    • I’ve found the best resources to be upperclassmen (especially for MS1s). Attending various interest group meetings is always interesting; not only do you learn about different specialties, but you see what kind of people are typically interested in those residencies. The latter was extremely influential for me.

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