How the residency Scramble works

March 15, 2011 at noon (Eastern time) is the first time you will be able to access the dynamic list of Scramble programs with open positions. (it's a dynamic list because as programs fill, the NRMP is supposed to take them off the list - roughly once per hour the list will be cut down, but they don't add new programs) These are only available as PDFs, so you will need Adobe Reader or a similar program to view them.

You and your advisor (having an advisor help you is crucial!) should log into the NRMP website, look through the list of programs, and decide who to contact first. For example, maybe your advisor was a classmate of a program director and chooses to call her first on your behalf. And you might decide that there's no way you would work in Kansas or Nebraska, so you cross those programs off the list. But basically you'll start by reviewing the programs and deciding who to call. This is a long process. It's hard to get through to a program director so you (or your advisor) will be leaving a lot of messages.

If you two do get someone on the phone, there's no single "right" way to proceed. Often the advisor will speak on your behalf, briefly advocating for you, describing your skills and why you'd be a great candidate. Then hopefully you'd be able to have a short phone interview with the program director, who would encourage you to send your application via ERAS. But maybe a program coordinator will answer the phone and say that a Scramble spot has already been filled (some open positions are filled almost instantly, even though the NRMP would still show it as being open until the database was finally updated). Or you might simply be told that the program will not take any international graduates during the Scramble, and you'll never be able to get on the phone to plead your case. Or they might not want to speak to your advisor at all and only want to talk to you. In the end, you'll follow up by transmitting your official application.

According to the program directors I've spoken to over the years, they really want to get your application via ERAS, not by fax or email. That means that paying a company to fax your application is usually a waste of money. But of course you should do whatever you think is best. You will be able to apply to a maximum of forty-five new programs through ERAS (specifically 30 on the first day of the Scramble, 10 on the second day, and 5 on the third day). You cannot pay ERAS to apply to more programs.

But since ERAS limits how many new programs you can send an application to, many people do not send out their applications through ERAS during the Scramble before talking to program directors or program coordinators. If there are more than forty-five open positions in Internal Medicine, you don't want to waste one of your applications by applying somewhere that's already full or a place that doesn't want an international graduate. Forming a personal connection first is crucial. The hope is that the mini phone interview will help them get to know you and want to know more about you by reading your entire application. Remember that during the phone conversation, they basically know nothing about you, so that's why your advisor introduces you, and then you briefly describe yourself and your strengths.

While it's true that some Scramble applicants will get match offers quickly, many others will send out their applications through ERAS and then wait to hear back. Since the program directors don't need to fill the positions blindly, some do take the time to read every page of every new application and then decide who should visit for an interview. Interviews sometimes occur throughout the spring before someone is offered a residency contract.

I wish you the best of luck during the Scramble. If you have trouble matching and need to reapply next year, please let me know if I can help.