Thalamus Blog: The Ultimate Guide to Medical Residency

Confessions of a Program Director: Interacting with the Electronic Residency Application Service (ERAS) on September 15th.

Posted by: in Application Tips , Confessions of a PD , ERAS

Date: August 26, 2019

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It never ceases to amaze the students I advise that my view of ERAS is quite different than theirs. As proof, I actually open up ERAS to show them how their application is displayed for me as a program director. 

I bet you were hoping I would take a screenshot and show you. Alas, ERAS is not open yet—and I need to get permission from someone to show it to you.

In the meantime, you might find it helpful to know how we, program directors and coordinators, process your applications.

They get filtered first

First, many program directors have nothing to do with a candidate’s application until after the initial legwork is out of the way (I may be an exception since I am a bit obsessed with the process…  but I digress.). What usually happens is that sometime before ERAS opens, the program decides on select filters that the coordinator will set in order to sift through the thousands of applications received. Feel free to read that again: many programs receive THOUSANDS OF APPLICATIONS. Nobody has the time or desire to read this many applications. Even if we could, assuming it took 10 minutes to read one of the 1000 applications, it would take 167 uninterrupted hours (one uninterrupted, entire week) to read all applications.  

To streamline this process, we set filters to the data fields which are collected in a typical spreadsheet, such as medical school, USMLE scores, and number of publications. ERAS even provides preset filters. It makes my job a lot easier when I can filter your applications by MD/DO/Foreign Graduate, and if I can tell if you were Alpha Omega Alpha (AOA). Then, I might want to prioritize inviting those with complete applications—are your letters of recommendation uploaded?  I can filter for “Dept Chair LoR Received” and that you also have three LoRs on file. Is your Dean’s Letter present? A filter for MSPE is easy to apply, too.

USMLE scores do count

And I know this is controversial, but your USMLE scores provide us a very useful filter. Many of us apply it with lower limits, too. We just have no other easy way of obtaining a clue into how well you acquire and process knowledge. Your MSPEs are PDFs. There is no way to translate your Dean’s letter into a “field”—and it is not efficient for us to review each letter for the initial screen anyway. For many MSPEs, we have no objective measure of how you even fared compared to peers. We wish this was a bit more standardized. 

And your medical school transcripts? I also need to individually open these up to see how you did. If your school is pass/fail, that is no help to me in discriminating you from others on that first pass. Unless you failed something. Then I place you in the “reviewed” and “not selected for interview” category. 

What on earth is “LOR3USMLE220USMDNotRev”?

This is the actual name of the first filter I will apply on that initial batch of ERAS applications: “LOR3USMLE220USMDNotRev”, which translates to “I will initially review your application and select you for interviewing (but maybe not invite you yet) if you have three letters on file, your USMLE Step 1 is over 220, you are a graduate of a medical school in the United States (my dean puts a lot of pressure on me to prioritize in this way), and I have not reviewed you yet (this allows me to do this in a running manner). This takes my initial list of 1979 applications down to about 843, no joke! 

ERAS has limitations

Looking at your view of ERAS, it is interesting to me that you are also limited by certain categories. One applicant just asked me how to log his current research project that has not yet resulted in a paper. Someone suggested he log this as an “extracurricular activity,” while I thought maybe it should be under “volunteer” activities (like when you work in a clinic during medical school). Either way, it is unlikely this information is going to be relevant for an initial screen. Rather, we would ask you about it during your interview. 

Consider your picture

And if I can give you one more piece of advice, it would be to ask someone to tell you how your picture looks on our screen. I have seen wrong pictures uploaded, and those that appear upside down. And though some places have even imposed a “we won’t look at your pictures” filter, I find it helps me remember you better. Even if you are applicant #647. 


Thalamus is a fantastic tool for managing the interview process, but there’s plenty of work that goes into processing applications before interviews can even begin! We hope that these confessions help to graduate med students to better understand the process, and how they can best position themselves for the career they want.

Written by: in Application Tips , Confessions of a PD , ERAS

Dr. Suzie Karan is a recently “retired” program director in the specialty of Anesthesiology. With over ten years of experience, she has reviewed over 10k applications. She also regularly advises medical students who are applying to residency. The idea of Thalamus was born of conversations between her and Dr. Jason Reminick during one particularly chaotic interview season that coincided with Hurricane Sandy. These are her stories.