It is no surprise that Otolaryngology remains one of the most competitive residency specialties year after year. Within the last 10 years, the percent of US allopathic graduates who matched on their first attempt has consistently fallen between 70-85%, the average USMLE STEP 1 score of matching applicants has been between 240-250 and most years there are less than 1 or 2 unfilled spots. The published 2014 match results for Otolaryngology (prepared by the National Resident Matching Program) provide some very interesting information and are definitely worth reviewing (Charting Outcomes in the Match, 5th Edition). 

Medical school represents an insanely busy time for most students with more things to do than time to do them in.  No student will have a flawless application in every area and most applicants do match.  Successful applicants are those that are able to prioritize their time to maximally improve their application in the areas that are given the most weight.  In order to give applicants a general idea of how various areas of the application are weighted, we have assigned the main criteria on which applicants are graded into 3 rough categories of importance.  Realize that different programs will vary in some areas, and not everyone will 100% agree on everything, but this table does provide a general idea.

Applicants should aim at being within the top 3rd of the class.  While outstanding grades in the first two years of medical school are helpful, program directors know that 3rd and 4th year clinical grades are one of the most reliable predictors of strong future residency performance.  Grades within the field (sub-I and visiting rotations) are given the strongest weight, followed closely by grades within certain core rotations such as medicine and surgery.  Do not freak-out if you do not receive honors on every rotation – extremely few applicants honor every class.  Obviously, focus your energy on the rotations that carry the most weight.  Like all surgical fields, having AOA on your application is extremely helpful for getting noticed by top programs.  While AOA membership will by no means guarantee residency placement, it does help get interviews.  Selection committees know that many medical schools do not have AOA chapters and additionally, criteria for induction vary from school to school.  AOA is helpful but not necessary to match at a top program. After all only about 30-40% of applicants are members.

Your USMLE Step 1 score is one of the few factors that most programs will initially use to narrow down their application number from 300 to 100.  Make sure that you allocate ample time toward studying for this exam so that you score well.    Many, but not all, programs will use arbitrary cut-off scores to help determine who they will invite for an interview -- having a score of ≥ 230 will usually make the cut at most places.  Remember that your application is a package deal (not just your board score) so if your score is significantly less than the 235-240 average, you should focus on making up for this deficit in other areas of your application.  One good way that applicants can make up for less than ideal performance on Step I is to take Step II early enough for it to be added to the application and of course, to nail it!  If you decide to go this route, you must be confident that you will increase your score by a significant amount.  If your USMLE score is already good, it may be risky to take Step II early since you have more to lose by scoring poorly. 

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