Anesthesiology residency 2025-2026 application cycle advice

[pvz3456]

Hi everyone! I wanted to get some advice on applying to anesthesiology for the 2025-2026 application cycle. I applied only for ophtho residency this match cycle (without submitting ERAS) and went unmatched last week. I am considering doing a research year in ophtho and then dual applying ophtho and anesthesiology for the 2025-2026 match cycle. I am currently on my anesthesiology rotation at my home institution.

My stats are as follows:

- US MD 4th year medical student at mid-tier school
- Top 5% of medical school class (honored all 3 years of medical school)
- Junior AOA
- Honored IM, surgery, pediatrics, OBGYN, high passed EM, FM, psych, and neurology, honored 4 ophtho rotations (1 home rotation and 3 aways)
- Step 2 score: 248
- 6 ophtho pubs (1 first author), 7 pulmonology pubs (1 first author), 1 nephro review paper
- 24 oral and poster presentations across ophtho and pulmonology
- Leadership involvements were in ophtho interest group and a free clinic, volunteer involvements in many student-run free clinics
- No anesthesiology publications, presentations or leadership/volunteer activities

The questions that I had were:
1. Am I competitive for anesthesiology?
2. If I were to dual apply ophtho and anesthesiology for the 2025-2026 residency application cycle, would it increase my chances to match into anesthesiology if I SOAP into a preliminary - internal medicine or surgery program/TY vs doing the research year in ophtho?
3. How important is anesthesia research for residency?
4. Is a LOR from an anesthesia attending required for residency?
5. If my goal is to match an academic medical center for anesthesia, what would be the best way to structure my application for residency? Should I leave out any ophthalmology research in the application?
6. How many programs should I apply to given my stats?

I would also welcome any advice about my next steps in addition to the questions I asked above. Thank you all for your time!!

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[lolnotacop]

Hi everyone! I wanted to get some advice on applying to anesthesiology for the 2025-2026 application cycle. I applied only for ophtho residency this match cycle (without submitting ERAS) and went unmatched last week. I am considering doing a research year in ophtho and then dual applying ophtho and anesthesiology for the 2025-2026 match cycle. I am currently on my anesthesiology rotation at my home institution.

My stats are as follows:

- US MD 4th year medical student at mid-tier school
- Top 5% of medical school class (honored all 3 years of medical school)
- Junior AOA
- Honored IM, surgery, pediatrics, OBGYN, high passed EM, FM, psych, and neurology, honored 4 ophtho rotations (1 home rotation and 3 aways)
- Step 2 score: 248
- 6 ophtho pubs (1 first author), 7 pulmonology pubs (1 first author), 1 nephro review paper
- 24 oral and poster presentations across ophtho and pulmonology
- Leadership involvements were in ophtho interest group and a free clinic, volunteer involvements in many student-run free clinics
- No anesthesiology publications, presentations or leadership/volunteer activities

The questions that I had were:
1. Am I competitive for anesthesiology?
2. If I were to dual apply ophtho and anesthesiology for the 2025-2026 residency application cycle, would it increase my chances to match into anesthesiology if I SOAP into a preliminary - internal medicine or surgery program/TY vs doing the research year in ophtho?
3. How important is anesthesia research for residency?
4. Is a LOR from an anesthesia attending required for residency?
5. If my goal is to match an academic medical center for anesthesia, what would be the best way to structure my application for residency? Should I leave out any ophthalmology research in the application?
6. How many programs should I apply to given my stats?

I would also welcome any advice about my next steps in addition to the questions I asked above. Thank you all for your time!!

1. Yes

2. Anesthesia is now competitive. Your application is competitive. But showing interest in another specialty and using anesthesia as your backup plan is a good way to fall down a program’s rank list.

3. It’s getting more important. Having research is better than not, anesthesia-specific being the best. See my answer to #2.

4. Generally, yes.

5. See answer to #2.

6. With the “signals” now in play, our program will screen applicants with geographic ties and those that used a signal specifically for our program. Otherwise, applications are usually screened out.

 

[Drwine]

Thirty or forty years ago you could have had your pick of anesthesiology residencies but that has changed . I didn't match in ophthalmology and dual applied the second time around and ended up in my second choice. No regrets.

 

[aneftp]

Thirty or forty years ago you could have had your pick of anesthesiology residencies but that has changed . I didn't match in ophthalmology and dual applied the second time around and ended up in my second choice. No regrets.

I wouldn’t say 30-40 years ago. 1990-1992 were super competitive years. That’s 35 years ago.

Also the 1986 cycle was competive since the ABA was switching from a 1 plus 2 residency to a 1 plus 3 residency (4 years) lots of IM docs made the switch into anesthesia for that reason.

But 1995-1997 ridiculously easy

But I do feel really bad for us grads who don’t get a spot in any match. Something needs to be done. The 1997 Clinton law signed was horrible for society. Led to not only the housing crash by making people greedy to use homes as atm rather than tax them on profits unless they rolled the profits into new homes. But it limited residency slots and tied it to Medicare funding.

Which seem ok at the time as Mercer medical school and university of south Florida were the only two medical schools opened newly opened within a 20 year period.

But we have (I lost track) maybe 25 new lcme? Schools opened since 2000? Plus new DO schools which do not have the same stigma it used to in the past.

 

[Sevo]

If a program figures out that you're using anesthesia as a back up plan, they're not going to rank you. Too many good applicants now. This isn't 1996.

 

[nimbus]

I wouldn’t say 30-40 years ago. 1990-1992 were super competitive years. That’s 35 years ago.

Also the 1986 cycle was competive since the ABA was switching from a 1 plus 2 residency to a 1 plus 3 residency (4 years) lots of IM docs made the switch into anesthesia for that reason.

But 1995-1997 ridiculously easy

But I do feel really bad for us grads who don’t get a spot in any match. Something needs to be done. The 1997 Clinton law signed was horrible for society. Led to not only the housing crash by making people greedy to use homes as atm rather than tax them on profits unless they rolled the profits into new homes. But it limited residency slots and tied it to Medicare funding.

Which seem ok at the time as Mercer medical school and university of south Florida were the only two medical schools opened newly opened within a 20 year period.

But we have (I lost track) maybe 25 new lcme? Schools opened since 2000? Plus new DO schools which do not have the same stigma it used to in the past.

I matched in 1992 (yeah I’m old). If you were an average medical student at a highly ranked medical school you had your pick of programs. Most of my classmates who matched anesthesia were average students and every single one matched at top programs. I was just a quiet hardworking unexceptional medical student. I had good board scores and some inconsequential basic science research, but no publications and no other activities but still interviewed at all the top programs and matched my first choice. At that time it was harder to match IM at MGH/Brigham/Stanford et al than it was to match anesthesia. I don’t know if that is the case now. I think the anesthesia match (and medical school admission) is more competitive now than it was then.

In 1995 or 1996 there was a WSJ article about a recent Stanford anesthesia grad who couldn’t find a full time job and had to drive around all over Northern California to piece together a living. That caused the anesthesia match to collapse for the incoming 1997-1998 classes. I think the number of USMDs entering the anesthesia match went from >1100 to <300.

 

[aneftp]

I matched in 1992 (yeah I’m old). If you were an average medical student at a highly ranked medical school you had your pick of programs. Most of my classmates who matched anesthesia were average students and every single one matched at top programs. At that time it was harder to match IM at MGH/Brigham/Stanford et al than it was to match anesthesia. I don’t know if that is the case now. I think the anesthesia match is more competitive now than it was then.

In 1995 or 1996 there was a WSJ article about a recent Stanford anesthesia grad who couldn’t find a full time job and had to drive around all over Northern California to piece together a living. That caused the anesthesia match to collapse for the incoming 1997-1998 classes. I think the number of USMDs entering the anesthesia match went from >1100 to <300.

The anesthesia slots have shot up 70 percent as more med schools opens

“Between 2002 and 2021, the number of anesthesiology residency positions increased 63%, from 1,169 to 1,907 (Figure 2).

Yes 1995-1995 were super bad years (for new grads). The ones in practice were still doing ok.

 

[NicholasPavona]

Thank God I got in when I did because boys...my file would be thrown in the trash IMMEDIATELY nowadays.

 

[nimbus]

Thank God I got in when I did because boys...my file would be thrown in the trash IMMEDIATELY nowadays.

So would mine. Pretty sure I wouldn’t be admitted to med school or even college if I applied now. I don’t have the drive to jump through all the new hoops.

 

[aneftp]

So would mine. Pretty sure I wouldn’t be admitted to med school or even college if I applied now. I don’t have the drive to jump through all the new hoops.

I don’t think so. You compete with your own cohort. If you were good to get back in than. You were good enough to get in these days.

There was a post a while ago where the written exam passing rate for first time test takers these days is 88%? Vs the old days first time passing rate around 72%?

And mention of rapid and vast access to old test data bank questions these days. Unlike the old days where the ABA released some old test question bank from years back.

It’s just a different game these days how to compete and get in. Different set of rules (new hoops as you mention). I do learn new things working with newer grads. I’m always willing to. Because you can become a dinosaur quickly after you get out of residency. One of the advantages of doing locums are various places. I’m like Man. This place is practicing medicine like it was 20 years ago and it’s outdated.

 

[Guillemot]

My experience with anesthesiologists is that there is an exponential increase in likelihood that they are a mor0n the greater their age.

Before anyone tries to conflate not being up to date on the latest study with intelligence, let me stop you right there. That’s not what I’m talking about about.

I’m not sure how to explain the phenomenon exactly. Maybe it’s partially explained by survival bias. Maybe it’s partiality explained by the dearth of applications/lack of competitiveness circa late 90’s - early 00’s. Anyway, it doesn't really matter. The point of my post is just to warn the uninitiated that the ostensibly competent, confident, grizzled, veteran may very well be a m0ron.

 

[aneftp]

My experience with anesthesiologists is that there is an exponential increase in likelihood that they are a mor0n the greater their age.

Before anyone tries to conflate not being up to date on the latest study with intelligence, let me stop you right there. That’s not what I’m talking about about.

I’m not sure how to explain the phenomenon exactly. Maybe it’s partially explained by survival bias. Maybe it’s partiality explained by the dearth of applications/lack of competitiveness circa late 90’s - early 00’s. Anyway, it doesn't really matter. The point of my post is just to warn the uninitiated that the ostensibly competent, confident, grizzled, veteran may very well be a m0ron.

Funny.

But than again there are some really bad newer anesthesia programs out there the last 15 years. Can the same be said about those newly graduated residents being pretty bad as well? I’ve seen my fair share the last several years.

Same if you went to a newer medical school created in the last 20 plus years.

 

[Guillemot]

Funny.

But than again there are some really bad newer anesthesia programs out there the last 15 years. Can the same be said about those newly graduated residents being pretty bad as well? I’ve seen my fair share the last several years.

Same if you went to a newer medical school created in the last 20 plus years.

If you’re trying to say that you’re unaware of the demographic that I am describing, I’ve got a hunch about the reason. 😉

 

[aneftp]

If you’re trying to say that you’re unaware of the demographic that I am describing, I’ve got a hunch about the reason. 😉

I’m 50. Some older dudes are smarter. Some younger dudes are dumber.

 

[Caninehalitosis]

I am of the cohort Guillemot refers to. I don't think ***** is a fair description of docs who finished residency in the 90's. (***** = IQ 50-70) Furthermore there is no way it is an exponential function {Mor0n(t)=Mor0n(0)e(t). e=2.718281828459...} These were the same docs applying to medical school in the 80's which was a competitive era. Docs of that era as well of docs of today skew rightward on the bell curve of intelligence. On balance the slight mental decline with age is balanced with the wealth of experience such that one can remain competent into the 60's. There is probably some selection bias. The smart docs are probably better able to retire earlier due to better life choices (invest well, don't get divorced, live well within your means) A life of poor choices probably keeps one working into the retirement age and skews that population. If one stays abreast of innovations, learns to do the new stuff that is developed, works in a trauma center, does hearts, reads some, and does his/her own cases he/she should remain competent.

My Delta airline buddy was retired at age 65. He could easily fly a couple more years but the law precludes it. Ageism is an issue in medicine but 65 is not the age. There is no specific mandatory retirement age nor competency evaluation for docs but early 70's is probably the age where competency evaluations become reasonable.

 

[Caninehalitosis]

PS: a review of exponential growth (green line)

 

[aneftp]

Getting back on subject. Apply for both specialties.

Focus on ur home institution for intern work or something while u can.

1. Do you have an prelim slot for next year?

Or will you need to scramble in March?

 

[AnonymousPD]

pvz3456,

As we are putting a bow on our 2025 rank list, this is actually a good time to answer many of the questions you have in your post. I'm not exactly sure what the shelf life is of a non-politically oriented post, but hopefully a week or so later you will still get a chance to see this. 🙂

Before you do anything, I would strongly advise you to do everything you can to figure out why you weren't successful in the Ophtho match. While your step 2 is certainly below average, I would wager with between 400-500 residency positions, there might be 100-200 students who matched that have paper accomplishments that are roughly equal to yours or worse. If you don't successfully get at the heart of what your weaknesses were this cycle, I guarantee those same issues will cause you problems in future cycles.

Some generalized advice before getting to your specific questions. If you do a year of Ophtho research and then apply to a bunch of categorical Anesthesiology residencies next year, you might as well take the money you were going to spend on those applications and light it on fire. In this competitive environment, the majority of PDs are going to look at someone who is obviously reapplying to Ophtho and take a pass. Every PD will honestly tell you that they have had great success with residents who originally went unmatched in some other specialty, but the world now is a flood of strong applicants, all of whom are picking Anesthesiology as their first choice. Why take a chance or extend a limited interview position to someone who is clearly focused on something else? The competitive disadvantage you would be putting yourself at is significant.

Out of curiosity...how many interviews did you receive this year?

As for your questions:
1. Yes. The basics of what you outlined about your medical school accomplishments mean your application will be closely reviewed by the majority of programs that you either gold or silver signal. But while I can guess that most will conclude you have the ability to be a good resident, what they think about your suitability for their program or this specialty will hinge on other things.
2. Yes. See above. Compared to doing a year of ophtho research, doing a prelim intern year and demonstrating clinical excellence in the few short months you have before next year's applications is a better option.
3. Depends on program. Does it help? Yes. Is it an absolute dealbreaker overall? No. Everyone will know your first choice was ophtho, how you explain your change of heart is everything.
4. Yes. Preferably one from the PD at your home program that says they will crawl over a mile of broken glass in order to get you to stay.
5. Too complex to go over here.
6. The vast majority of programs are interviewing withing their program signals. So any additional applications you send out beyond those will experience significantly diminishing returns. That said, you miss 100% of the shots you don't take. So knowing that, the answer will come down to what your available resources are and the overall strength of your application 6 months from now. Your home program should have faculty advisors who can help you with this.

 

[pvz3456]

Getting back on subject. Apply for both specialties.

Focus on ur home institution for intern work or something while u can.

1. Do you have an prelim slot for next year?

Or will you need to scramble in March?

No prelim spot next year since SOAP opens up March 17 so I will need to scramble

 

[pvz3456]

pvz3456,

As we are putting a bow on our 2025 rank list, this is actually a good time to answer many of the questions you have in your post. I'm not exactly sure what the shelf life is of a non-politically oriented post, but hopefully a week or so later you will still get a chance to see this. 🙂

Before you do anything, I would strongly advise you to do everything you can to figure out why you weren't successful in the Ophtho match. While your step 2 is certainly below average, I would wager with between 400-500 residency positions, there might be 100-200 students who matched that have paper accomplishments that are roughly equal to yours or worse. If you don't successfully get at the heart of what your weaknesses were this cycle, I guarantee those same issues will cause you problems in future cycles.

Some generalized advice before getting to your specific questions. If you do a year of Ophtho research and then apply to a bunch of categorical Anesthesiology residencies next year, you might as well take the money you were going to spend on those applications and light it on fire. In this competitive environment, the majority of PDs are going to look at someone who is obviously reapplying to Ophtho and take a pass. Every PD will honestly tell you that they have had great success with residents who originally went unmatched in some other specialty, but the world now is a flood of strong applicants, all of whom are picking Anesthesiology as their first choice. Why take a chance or extend a limited interview position to someone who is clearly focused on something else? The competitive disadvantage you would be putting yourself at is significant.

Out of curiosity...how many interviews did you receive this year?

As for your questions:
1. Yes. The basics of what you outlined about your medical school accomplishments mean your application will be closely reviewed by the majority of programs that you either gold or silver signal. But while I can guess that most will conclude you have the ability to be a good resident, what they think about your suitability for their program or this specialty will hinge on other things.
2. Yes. See above. Compared to doing a year of ophtho research, doing a prelim intern year and demonstrating clinical excellence in the few short months you have before next year's applications is a better option.
3. Depends on program. Does it help? Yes. Is it an absolute dealbreaker overall? No. Everyone will know your first choice was ophtho, how you explain your change of heart is everything.
4. Yes. Preferably one from the PD at your home program that says they will crawl over a mile of broken glass in order to get you to stay.
5. Too complex to go over here.
6. The vast majority of programs are interviewing withing their program signals. So any additional applications you send out beyond those will experience significantly diminishing returns. That said, you miss 100% of the shots you don't take. So knowing that, the answer will come down to what your available resources are and the overall strength of your application 6 months from now. Your home program should have faculty advisors who can help you with this.

I had 10 interviews. During practice interviews, I was told I interviewed well and even feedback from PDs after I did not match was not related to the interviews. One PD said my letters could have been better. I am thinking I get an interview coach for the next cycle and learn how to "market" myself better

 

[CopaceticOne]

I had 10 interviews. During practice interviews, I was told I interviewed well and even feedback from PDs after I did not match was not related to the interviews. One PD said my letters could have been better. I am thinking I get an interview coach for the next cycle and learn how to "market" myself better

And get new LORs. If that is what the PD said, one or more of them is not good.

 

[AnonymousPD]

I had 10 interviews. During practice interviews, I was told I interviewed well and even feedback from PDs after I did not match was not related to the interviews. One PD said my letters could have been better. I am thinking I get an interview coach for the next cycle and learn how to "market" myself better

Even though this is a bit of an oversimplification, it is somewhat helpful to look at this as a zero sum game.

If you take 2 applicants, if applicant A is superior than applicant B in one category. Applicant B must be better than applicant A in some other category just to get back to even standing. So if you are starting from a position where your board scores and letters of recommendation are below the average of the applicant pool, you can't just have an "okay" interview. If you want to be successful, you need to leave a GREAT impression after your interview, your personal statement has to be awesome, your extracurriculars and the rest of your application need to sparkle. That's how you need to approach this.

If you have reason to suspect your letters might be somewhat lukewarm, that's something you need to address immediately. Most letters typically say the same things about how great students are. It really stands out is when you run across one that is somewhat lukewarm.

Getting someone to help you with your interviews is always a good idea. Who were you practicing with? Make sure you get help from someone who is/was involved in residency selection. What sounds good to someone not involved in the process could very well be standard and uninteresting to someone who hears the same response from a hundred candidates a year.

 

[aneftp]

And get new LORs. If that is what the PD said, one or more of them is not good.

Letter of recommendation rarely matter to be honest. Especially in competitive specialities.

All about scores, and if it’s a toss up between two equal candidates, the general vibe how the program director feels about a candidate.

It’s very stressful unfortunately that fate of the match depends on this for many borderline applicants.

 

[CopaceticOne]

Letter of recommendation rarely matter to be honest. Especially in competitive specialities.

All about scores, and if it’s a toss up between two equal candidates, the general vibe how the program director feels about a candidate.

It’s very stressful unfortunately that fate of the match depends on this for many borderline applicants.

I will disagree with you, especially for less than stellar letters. I am involved with the process at my institution. When were you last a part of the ranking discussions?

 

[aneftp]

I will disagree with you. I am involved with the process at my institution. When were you last a part of the ranking discussions?

Long time ago 2014.

Do things change? Not much has changed even over 25 years.

I think people try to reinvent the wheel.

 

[CopaceticOne]

Long time ago 2014.

Do things change? Not much has changed even over 25 years.

I think people try to reinvent the wheel.

Well, step scores are now P/F. So yes, things do change. You are out of date in this one.

 

[aneftp]

Well, step scores are now P/F. So yes, things do change. You are out of date in this one.

So why are people discussing step scores ?

“Step 2 score: 248”

Explain that ….

Why not get rid of step 1 and 2 scores?

 

[pvz3456]

Even though this is a bit of an oversimplification, it is somewhat helpful to look at this as a zero sum game.

If you take 2 applicants, if applicant A is superior than applicant B in one category. Applicant B must be better than applicant A in some other category just to get back to even standing. So if you are starting from a position where your board scores and letters of recommendation are below the average of the applicant pool, you can't just have an "okay" interview. If you want to be successful, you need to leave a GREAT impression after your interview, your personal statement has to be awesome, your extracurriculars and the rest of your application need to sparkle. That's how you need to approach this.

If you have reason to suspect your letters might be somewhat lukewarm, that's something you need to address immediately. Most letters typically say the same things about how great students are. It really stands out is when you run across one that is somewhat lukewarm.

Getting someone to help you with your interviews is always a good idea. Who were you practicing with? Make sure you get help from someone who is/was involved in residency selection. What sounds good to someone not involved in the process could very well be standard and uninteresting to someone who hears the same response from a hundred candidates a year.

Thanks for this great advice! I do agree with the zero-sum game approach and that totally makes sense. I was practicing interviews with a resident, my medical school admin and my family, though I understand these people are not directly involved with selecting candidates for residency. Would residents and attendings involved in residency selection be great resources to practice my interview skills with or would you suggest someone else?

 

[AnonymousPD]

Thanks for this great advice! I do agree with the zero-sum game approach and that totally makes sense. I was practicing interviews with a resident, my medical school admin and my family, though I understand these people are not directly involved with selecting candidates for residency. Would residents and attendings involved in residency selection be great resources to practice my interview skills with or would you suggest someone else?

See above.

 

[klu6199]

1. Yes

2. Anesthesia is now competitive. Your application is competitive. But showing interest in another specialty and using anesthesia as your backup plan is a good way to fall down a program’s rank list.

3. It’s getting more important. Having research is better than not, anesthesia-specific being the best. See my answer to #2.

4. Generally, yes.

5. See answer to #2.

6. With the “signals” now in play, our program will screen applicants with geographic ties and those that used a signal specifically for our program. Otherwise, applications are usually screened out.

Any insight on how programs view program signals without a geographic signal? I know ideally both would align, but I'm looking at applying to a few specific programs in regions where I likely won't apply to other programs, so I probably won't use one of the three geo signals for those.

Also, I've heard that program signals are becoming basically a requirement to get an interview at pretty much every program. Any idea if it would still be worth it to apply to programs in your geographic signal region, but that you didn't send a program signal to?

 

[BLADEMDA]

Hi everyone! I wanted to get some advice on applying to anesthesiology for the 2025-2026 application cycle. I applied only for ophtho residency this match cycle (without submitting ERAS) and went unmatched last week. I am considering doing a research year in ophtho and then dual applying ophtho and anesthesiology for the 2025-2026 match cycle. I am currently on my anesthesiology rotation at my home institution.

My stats are as follows:

- US MD 4th year medical student at mid-tier school
- Top 5% of medical school class (honored all 3 years of medical school)
- Junior AOA
- Honored IM, surgery, pediatrics, OBGYN, high passed EM, FM, psych, and neurology, honored 4 ophtho rotations (1 home rotation and 3 aways)
- Step 2 score: 248
- 6 ophtho pubs (1 first author), 7 pulmonology pubs (1 first author), 1 nephro review paper
- 24 oral and poster presentations across ophtho and pulmonology
- Leadership involvements were in ophtho interest group and a free clinic, volunteer involvements in many student-run free clinics
- No anesthesiology publications, presentations or leadership/volunteer activities

The questions that I had were:
1. Am I competitive for anesthesiology?
2. If I were to dual apply ophtho and anesthesiology for the 2025-2026 residency application cycle, would it increase my chances to match into anesthesiology if I SOAP into a preliminary - internal medicine or surgery program/TY vs doing the research year in ophtho?
3. How important is anesthesia research for residency?
4. Is a LOR from an anesthesia attending required for residency?
5. If my goal is to match an academic medical center for anesthesia, what would be the best way to structure my application for residency? Should I leave out any ophthalmology research in the application?
6. How many programs should I apply to given my stats?

I would also welcome any advice about my next steps in addition to the questions I asked above. Thank you all for your time!!

Here is my advice FWIW. Anesthesiology should be your primary application and Optho the secondary one. Your odds of matching Optho the second time around is lower so why gamble with your future? If you can be satisfied with Anesthesiology as your career then take the higher probability match. Even with your application stats I would recommend second tier programs as the focus.

 

[Gern Blansten]

From a program’s point of view, taking an applicant who wanted a different specialty has an inherent risk. Number one, they likely know very little about your specialty. All of their focus has been on their primary specialty pick. Number two, if a position comes open unexpectedly in their primary pick of specialties at any point in the next couple of years, they are a flight risk. I’ve seen it happen. That leaves the PD scrambling to fill a spot, likely from a much lower quality pool of candidates. So, if I were the PD and I saw evidence that someone is dual applying, I would not take them very seriously. They would need to be a far above average candidate who knows our specialty well. An average resident who is happy and committed to the specialty and the program is far better than the outstanding candidate (on paper) who doesn’t want to be in your program or your specialty.

That is very different than a candidate who has done a year or more in another specialty and realizes they have made a terrible career choice. They typically show up appreciative and ready to work hard to show appreciation for you taking a chance on them. The chances they leave the program in search of a third residency are very low. Plus you have a track record of their work of 1-3 years in the other specialty, which tends to be a really good marker of how they will do in their new specialty. You will typically know their standing in the current program and whether they have chosen to leave or are being nudged out by the program. Many times, these happen at the local level, so the candidates are known well.

 

[scrubsandgas123]

Hi everyone! I wanted to get some advice on applying to anesthesiology for the 2025-2026 application cycle. I applied only for ophtho residency this match cycle (without submitting ERAS) and went unmatched last week. I am considering doing a research year in ophtho and then dual applying ophtho and anesthesiology for the 2025-2026 match cycle. I am currently on my anesthesiology rotation at my home institution.

My stats are as follows:

- US MD 4th year medical student at mid-tier school
- Top 5% of medical school class (honored all 3 years of medical school)
- Junior AOA
- Honored IM, surgery, pediatrics, OBGYN, high passed EM, FM, psych, and neurology, honored 4 ophtho rotations (1 home rotation and 3 aways)
- Step 2 score: 248
- 6 ophtho pubs (1 first author), 7 pulmonology pubs (1 first author), 1 nephro review paper
- 24 oral and poster presentations across ophtho and pulmonology
- Leadership involvements were in ophtho interest group and a free clinic, volunteer involvements in many student-run free clinics
- No anesthesiology publications, presentations or leadership/volunteer activities

The questions that I had were:
1. Am I competitive for anesthesiology?
2. If I were to dual apply ophtho and anesthesiology for the 2025-2026 residency application cycle, would it increase my chances to match into anesthesiology if I SOAP into a preliminary - internal medicine or surgery program/TY vs doing the research year in ophtho?
3. How important is anesthesia research for residency?
4. Is a LOR from an anesthesia attending required for residency?
5. If my goal is to match an academic medical center for anesthesia, what would be the best way to structure my application for residency? Should I leave out any ophthalmology research in the application?
6. How many programs should I apply to given my stats?

I would also welcome any advice about my next steps in addition to the questions I asked above. Thank you all for your time!!

Your step 2 is already below average with the matched anesthesia average rn (252). You have pretty good clinical grades but the step 2 isn’t adding up with all the honors in core rotations. So unless you use the year to show demonstrated interest in anesthesia and a LOR from an anesthesia attending, you probably won’t match next cycle with how competitive it’s getting each year/many people only applying anesthesia and are dead set on it.

 

[Gern Blansten]

Your step 2 is already below average with the matched anesthesia average rn (252). So unless you use the year to show demonstrated interest in anesthesia and a LOR from an anesthesia attending, you probably won’t match next cycle with how competitive it’s getting each year

If you’re top 5% of your class and junior AOA, you will match unless you totally blow it on the interviews. I would guess you will match at one of your top two picks. Your only potential downfall is if you’re not successful in convincing the PDs that you are not dual applying with anesthesiology and ophthalmology.
Your personal statement should address it and, hopefully, the letter writer who knows you best should tackle the topic so that there is no doubt. Do not submit an ophthalmology letter of recommendation unless you are dual applying.

 

[scrubsandgas123]

If you’re top 5% of your class and junior AOA, you will match unless you totally blow it on the interviews. I would guess you will match at one of your top two picks. Your only potential downfall is if you’re not successful in convincing the PDs that you are not dual applying with anesthesiology and ophthalmology.
Your personal statement should address it and, hopefully, the letter writer who knows you best should tackle the topic so that there is no doubt. Do not submit an ophthalmology letter of recommendation unless you are dual applying.

Overall, yeah I agree they’ll match with that app if they can think of a good explanation as to why anesthesia now. But any savvy anesthesia PD/APD knows AOA doesn’t mean anything now a days since most of it is purely a popularity contest. Grades, scores, research, extracurricular speak for themself

 

[Gern Blansten]

Overall, yeah I agree they’ll match with that app if they can think of a good explanation as to why anesthesia now. But any savvy anesthesia PD/APD knows AOA doesn’t mean anything now a days since most of it is purely a popularity contest. Grades, scores, research, extracurricular speak for themself

Junior AOA IS grades.

 

[scrubsandgas123]

Junior AOA IS grades.

Depends on the school, my school not really and same with others. Not to even mention how it historically works against URM and schools like Sinai recently got rid of it entirely