Based on the 2018 Program Director’s Survey published by the NRMP, the following factors were most important in deciding who to invite for an anesthesiology residency interview:

• Any failed attempt in USMLE/COMLEX

There is no question that a USMLE/COMLEX failure is a deal breaker for many programs. However, in our experience, this is “easier” to overcome if you are a US allopathic student. The 2018 Program Director’s Survey indicated that 66% of programs rarely consider an applicant with a Step failure and 35% never consider an applicant with a Step failure.

• USMLE Step 1/COMLEX Level 1 score

It is a fact of life that your performance on Step 1 or COMLEX 1 will impact the likelihood that your application is “screened in” and that you are invited for an interview. Many programs automatically screen out applications if the Step/COMLEX 1 score falls below a certain threshold. The 2018 Program Director’s Survey indicated that 88% of programs have a “target score” they like to see applicants earn. That cut off from most programs is between 210-220. By the same token, some programs automatically grant interviews for students with scores above a certain threshold. That threshold varies but is usually between 225 – 240 depending on the program. If you don’t do as well on Step 1 as you would have liked, take Step 2 CK early and do as well as you can!  The mean Step 2 CK score for US seniors who matched was 246.

• Evidence of Professionalism and Ethics

You might ask how your professionalism and ethics might be assessed based on your written application. Program directors glean information about your personal characteristics and traits from your anesthesiology personal statement, ERAS written application, and letters of reference. This is why it is important to compose your personal statement and ERAS work, research, and volunteer experience entries thoughtfully. It is empowering to know that the outcome of your application season is, in part, within your control at this stage of the process.

• Perceived commitment to specialty, personal prior knowledge of the applicant, grades in clerkship in desired specialty, audition elective/rotation within your department, letters of recommendation in the specialty.

Anesthesiology program directors want to understand your commitment to the specialty and that you have adequately demonstrated that interest by doing as much as possible to learn about the practice of anesthesiology and gain exposure. You can express this commitment though your anesthesiology personal statement and ERAS experience entries. Of course, if you are known and well liked by a program to which you are applying, this is a real plus which is why away electives and audition rotations can be beneficial in the residency admissions process. This is especially important if you are less competitive applicant or you hope to train in a geographically competitive area. Letters of recommendation from anesthesiologists who know you well is also of the utmost importance. Ideally, applicants should have two letters of reference written by academic anesthesiologists. Additional letters from intensivists, internists and surgeons are also valuable.