When applying to residency, how much do gaps in your medical training influence your chances at matching? A gap can be a period of months, or more devastatingly, years where you are not participating in any sort of clinical experience. It is often unclear how important it is to have minimal breaks in your medical education. Match season is underway and many applicants are applying to residency programs through ERAS, the National Resident Matching Program’s (NRMP) Main Electronic Residency Application System, but unfortunately are left wondering why they are not receiving interviews.
According to the results of the 2014 NRMP Program Director Survey, 70% of Program Directors listed gaps in medical education as an important factor when choosing who to interview for residency. When ranking applicants after the interview, only 45% of Program Directors cited gaps in medical education as important. Despite the decrease in the importance of gaps from the initial interview to the ranking process, most applicants with large gaps in their CV will not even have the chance to prove themselves. Only applicants that receive interviews are given the opportunity to make positive impressions or to explain the reasons for the gaps in their CV.
What is considered a gap in medical education?
A gap can happen for many different reasons. Personal issues or studying for exams are amongst the most common. For example, you might take a break from practicing medicine while studying for the United States Medical Licensing Examinations (USMLE) after graduating from medical school. Although this may benefit your scores, a Program Director will still look negatively upon a gap in your CV. The longer the gap period, the more issues an applicant may encounter, especially if you are an International Medical Graduate who takes years to become ECFMG certified. Those who take a substantial amount of time to complete their exams without participating in medicine are competing against other applicants who have taken their exams during medical school and therefore do not show any discontinuities in their CV. They are also up against countless others who are balancing externships, observerships, and research while preparing for their Steps. It is important to note that this time taken off for studying will not be available during the first year of residency when most people prepare for Step 3, and Program Directors take this into account when considering you for their programs.
When is a gap the most devastating to your application?
A gap in medical training is the most detrimental to your application if you have graduated from medical school more than 2-3 years ago and have not been actively participating in medicine. According to the 2014 NRMP Program Director Survey, different specialties give different weight to the importance of gaps in medical education when selecting who to interview and in ranking applicants:
*Percentage of Program Directors who cited gaps in medical education as important for selecting applicants to interview and in ranking applicants
As shown in the graph above, a higher percentage of Program Directors for Family Medicine and Psychiatry view gaps in medical education as important.
What can be done to offset the gaps?
Whatever the reason for the gaps in your medical education, there are always opportunities to counteract these gaps in order to improve your CV. If you are planning on taking a break from your medical training to study for the USMLE, consider volunteering in a doctor’s office or clinic at least a few times a week. Doing some clinical work is better than doing none at all. You can also explain any large gaps in your medical training in your Personal Statement—especially if the leave of absence involves a personal reason.
Although you may not be active in the medical field while applying through ERAS and or while waiting to receive interviews, this is still a great time to enroll in externships. Externships will give you the opportunity to include recent clinical experiences in your application, you can mention the experiences in your interviews, and you have the potential to build relationships with the programs that you are involved with. Observerships can be beneficial as well, although most programs do not put a lot of value in them because they do not provide hands-on experience.
Don't make the mistake of letting gaps in your medical education upset your chances at residency. Whether you are currently applying to the Match, or are planning to apply in the upcoming years, make sure your CV is consistent and be smart in your preparations.