Planning Your Fourth Year

Priority Scheduling

You need to complete your Sub-Internship (Sub-I) early (blocks 9-12) to allow comments from the rotation to be included in your Structures Evaluative Letter (SEL-departmental letter). This means scheduling the Sub-I in June, July, or August.

Suggested Interview Months

Peak interview months are November and December. Some programs interview through January. Local programs may offer interviews as early as October. Highly competitive programs generally do not begin notifying applicants until late October.

Letters of Recommendation

  • You will submit 3-4 letters.
  • 1 Structured Evaluative Letter (SEL) written by leadership in the Department of Internal Medicine. This is formerly known as the departmental letter. AAIM Guidelines for IM SEL
  • 2-3 Letters of recommendation written by faculty (not residents), at least two of which should be from faculty in Internal Medicine or subspecialty medicine (e.g. cardiology, gastroenterology, etc.) is recommended. Some programs will allow you to upload 2 letters, other programs will allow you to upload 3.

Recommended Documents and Links

Last year ERAS piloted an optional “Supplemental” application to help students share more about themselves and assist program directors in finding applicants that fit their programs’ setting and mission. There is no cost to applicants or programs. The AAMC is evaluating data from the first year of the supplemental application. There are plans for a supplemental application in the 23-24 application cycle. The due date for this is September 16 2022. The date when the full ERAS application is due is TBD. Information about this  year’s supplemental application can be found on the AAMC Supplemental ERAS website.
Information on applying to IM can be found at the ACP web site. You must join to access but membership is free.
Information about programs can be found at AAMC Residency Explorer Tool. Local data related to USMLE scores and where students matched is available from the SOM.

Additional Recommendations

General Advice – Do not completely front load your schedule.

  • You do not want to have done all meaningful electives in the first half of the year so that you have the lightweight electives from January-graduation. You will be out of practice evaluating and making decision and not in the best shape for your internship.
  • Consider doing EM or ICU at the end of the year. You will be able to apply all that you learned and be prepared for your internship.


  • The number of places you apply to depends on your competitiveness.
  • If you are a marginal student (course failures, USMLE failure(s), etc.) you need to apply to a lot of Medicine programs—50 programs including mostly if not all community programs.
  • On average most people should apply to 20-25 programs.
  • Discuss your competitiveness with your Field Specific Advisor, Dr. Ananthakrishnan, and your letter writers.
  • Match data shows that students who have 6 interviews will a 95% likelihood of successfully matching.
  • Please relinquish interviews once you have 12-15 interviews to allow your peer applicants a chance to interview and match.
  • Contact your advisor or Dr. Ananthakrishnan if you do not have 6-10 interviews by the first week of November.