A New Norm: The Amplified Stress of Applying to Residency

“Promise me you’ll stay near the computer until I’m done, in case I get another invite today!” My Ob-Gyn residency interview started in 10 minutes. I should have been mentally preparing; instead, I was going over instructions with my mom (again) for watching for other residency interview invitations.

My mom kept her promise, but there was still a 15-minute period during which my inbox was unwatched and an invitation arrived. By the time my mom saw it, all the interview spots had filled, and I was automatically waitlisted. I was devastated, and my mom was torn with guilt.

Two months (and a lot of email checking) later, the interview season was seemingly finished, and I was on a much-needed vacation. On New Year’s Eve, I woke to the warm Mexican sun on my skin and was shocked when I glanced at my phone: I was off the waitlist, and my interview was in 5 days.

I spent the last day of 2018 frantically searching for a strong Wi-Fi connection. I repeatedly ran through a checklist in my head: confirm the interview; call the airline to change my flight itinerary; text a list of clothes and belongings for my parents to express mail; tell my attending I’d miss three days of work unexpectedly; book an appointment to change my tropical orange nails to a neutral, professional color…

I could not sleep that night for fear of forgetting something. Distracted by the complicated logistics, the one thing I did forget was to feel excited for the interview. The costs were exorbitant, and the stress was unnerving. Yet, I had not even thought to decline the invitation; it did not feel like an option. I did not merely want this interview; I felt that I needed it out of a deep-rooted fear of not matching.

When non-medical professionals hear my story, they are flabbergasted. When my classmates hear this story, they simply nod and launch into their own outrageous anecdotes. My story might be unique, but my situation is not. With the residency application process becoming increasingly competitive, the stress and financial burdens on applicants have only amplified.1,2

 It has become common for medical students and their loved ones to go to extreme lengths to schedule residency interviews. What’s meant to be an exciting milestone has become seven months of sleepless nights, glued to email inboxes, phones, and pagers (thanks to mail forwarding—both a blessing and a curse). A new and dangerous norm has taken shape: an extended period of self-doubt, fear, and resentment that is causing significant strain on applicants’ well-being. I fear these emotions will linger into the beginning of intern year, making me and my colleagues even more susceptible to burnout.3

As Frush and Byerley outline, the residency application process could be greatly improved through strategic changes to how interviews are offered and scheduled, thereby reducing applicant stress.2 Had there been a standard “offer week” for interview invitations, my mom and I would have been relieved of the anxiety of being “on-call” for months. With an interview cap for all applicants, my perceived need to accept all interview invitations, regardless of the logistical circumstances, would have been mitigated. My story, and those of my colleagues, are evidence that these and other efforts are crucial in order to provide the next cohort of MDs a more welcoming introduction to residency.

By: Salomeh M. Salari

S.M. Salari is a fourth-year medical student at University of Michigan Medical School, Ann Arbor, Michigan, who has matched at the Case Western Reserve University Hospitals Obstetrics and Gynecology residency program. Twitter: @Sally_Salari.

Editor’s Note: This trainee-authored blog post is part of the Advancing Trainee Leaders and Scholars (ATLAS) initiative, which aims to engage students, residents, and fellows in medicine, nursing, and pharmacy in the scholarly publishing process and feature their voices more regularly in Academic Medicine. You can read more ATLAS blog posts here and find out more about the ATLAS initiative here.


  1. Fogel HA, Liskutin TE, Wu K, Nystrom L, Martin B, Schiff A. The economic burden of residency interviews on applicants. Iowa Orthop J. 2018;38:9–15.
  2. Frush BW, Byerley J. High-value interviewing: A call for quality improvement in the Match process. Acad Med. 2019;94:324–327.
  3. Dyrbye LN, West CP, Satele D., et al. Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population. Acad Med. 2014;89:443–451.