How to Organize Your Application Information: In ERAS Format

How to Organize Your Application Information: A Simple Template

Applying for residency, fellowship, or other medical training programs is a process that requires careful preparation. Whether you're using the ERAS application or a different system, it's important to have all your information organized and ready. Here's a template designed with the ERAS application in mind, but it can be customized to fit any medical application. Use it to keep track of your key experiences, qualifications, and certifications, and feel free to modify it based on your needs.

Why You Need a Template

During residency, you accumulate numerous experiences, licenses, certifications, and publications. Keeping them organized ensures you’re always ready to apply for programs, research opportunities, or jobs. This template helps you store important details about your clinical roles, research, volunteering, and more, so you can avoid last-minute stress when it’s time to apply.

Below is the list -

1. Personal Infromation

2. Biographic Information

3. Educaiton

4. Experience

5. Licenses & Certifications

6. Publications

Application Template

PERSONAL INFORMATION

AAMC Account Information

AAMC ID:
Email Address:

You can create your AAMC account by visiting this link: https://www.aamc.org/. Through your account, you'll be able to access essential services like ERAS for residency applications, as well as other resources for medical students and graduates.

Basic Information

Full Name (as per your legal documents):
Phone Number:
Mobile Phone:
Alternate Phone:
Fax Number (if applicable):
Pager Number (if applicable):
Pronouns (e.g., he/him, she/her, they/them):

Address

Current Mailing Address:
Permanent Address:

Work Authorization

Are you currently authorized to work in the United States? (Yes/No):
Will you need visa sponsorship through ECFMG (J-1) or the teaching hospital (H-1B) to complete the entirety of your GME training? (Yes/No):
Type of Visa Sponsorship Required (if applicable):
If you currently reside in the United States or Canada, please specify:

State/Province:
City:

NRMP MATCH INFORMATION

Do you plan to participate in the NRMP Match? (Yes/No):
NRMP ID:
(Note: You will need to register separately with NRMP at https://www.nrmp.org)
Are you participating in the match with a partner? (Yes/No):

Partner’s Name (if applicable):
Specialties Partner is Applying To:

Identification Numbers

USMLE/ECFMG ID:

BIOGRAPHIC INFORMATION

Self-Identification

How do you self-identify?

American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White
Some other race or ethnicity (Specify):

Language Proficiency

Do you meet or exceed the Advanced level of proficiency in English?

Languages in which you meet or exceed the Good level of proficiency:

Hindi
Nepali
Other (Specify):

Language Proficiency*

Please use these definitions to assess and describe your level of proficiency in all the languages you speak.

Native/Near native - I converse easily and accurately in all types of situations, including communicating health care concepts. Native/near-native speakers may think that I am a native/near-native speaker too.

Advanced - I speak very accurately, and I understand other speakers very accurately. Language ability rarely hinders me in performing any task, including communicating health care concepts, requiring this language. Native/near-native speakers have no problem understanding me, but they probably perceive that I am not a native/near-native speaker.

Good - I speak well enough to participate in most conversations. Native/near-native speakers notice some errors in my speech or my understanding, but I am generally able to repair the conversation if errors or misunderstandings occur. I have some difficulty communicating health care concepts.

Fair - I speak and understand well enough to have casual conversations about current events, work, family, or personal life and can get the general idea of most everyday conversations. Native/near-native speakers notice many errors in my speech or my understanding. I have difficulty communicating about health care concepts.

Basic - I speak the language at a level that permits me to understand and respond to 2-3 word entry-level questions and meet minimum courtesy requirements. I have difficulty in or understanding conversations. I am unable to understand or communicate most health care concepts.

Military Information

Are you committed to fulfilling a U.S. military active duty service obligation?

Do you have any other service obligations (e.g., Military Reserves, Public Health/State programs)?

Geographic Preferences

Preferred U.S. Census divisions (select up to 3):

New England
Middle Atlantic
East North Central
West North Central
South Atlantic
East South Central
West South Central
Mountain
Pacific
No preference

Setting Preference

Preferred setting:

Rural
Suburban
Urban
No preference

Hometown(s)

City:
State/Province:
Country:
Postal Code:
Setting: [ ] Urban [ ] Suburban [ ] Rural
City:
State/Province:
Country:
Postal Code:
Setting: [ ] Urban [ ] Suburban [ ] Rural
City:
State/Province:
Country:
Postal Code:
Setting: [ ] Urban [ ] Suburban [ ] Rural

EDUCATION

Higher Education

Institution Name:
Dates Attended:
Degree Date:

Medical Education

Institution Name:
Dates Attended:
Degree Date

Postgraduate Training

(Add entries for AOA Internship, AOA Residency, AOA Fellowship, ACGME Residency, or ACGME/RCPSC/UCNS Fellowship.)

Institution Name:
Type of Training:
Dates Attended:
Degree Date:

Extensions & Interruptions

(Indicate if there have been any unplanned professionalism or academic issues causing interruptions or extensions in medical education or training.)

Have you had any unplanned interruptions or extensions?

Honors & Awards

Honor Societies

Alpha Omega Alpha Status: [--Select--]
Gold Humanism Honor Society Status: [--Select--]

Other Honors and Awards
(Please add any awards or honors you have received.)

Types- Honor society, Community/Service Recognition, Academic Excellence, Research, Scholarship, Grant, Other honor or awards classification.

[Add Award]

Professional Memberships

(Add current memberships in professional organizations, associations, or societies.)

Organization Name:

[Add Entry]

EXEPRIENCES

Selected Experiences

We would like to know more about the experiences that have shaped you personally and professionally. Please provide details for the following:

Key Experiences
Please identify and describe up to 10 experiences that highlight your personal passions, values, and what's most important to you.
(Include the name of the experience, your role, description, and the dates involved.)

FILL

ORGANIZATION -

EXPERIENCE TYPE - EDUCATION/TRAINING , MILITARY SERVICE, OTHER EXTRACURRICULAR ACTIVITIES/CLUBS, PROFESSIONAL ORGANIZATION, RESEARCH, TEACHING/MENTORING, VOLUNTEER/SERVICE/ADVOCACY, WORK

POSITION TITLE -

START DATE -

END DATE -

COUNTRY -

STATE / PROVINCE -

CITY -

POSTAL CODE -

PARTICIPATION FREQUENCY -

SETTING - RURAL/ URBAN/ VIRTUAL

PRIMARY FOCUS - BASIC SCIENCE, CLINICAL/ TRANSITIONAL SCIENCE, COMMUNITY INVOLVEMENT/ OUTREACH, CUSTOMER SERVICE, HEALTHCARE ADMINISTRATION, IMPROVISING ACCESS TO HEALTHCARE, MEDICAL EDUCATION, MUSIC/ ATHELETICS/ ART, PROMOTING WELLNESS, PUBLIC HEALTH, QUALITY IMPROVEMENT, SOCIAL JUSTICE/ ADVOCACY, TECHNOLOGY

KEY CHARACTERSTICS -

COMMUNICATION, CRITICAL THINKING AND PROBLEM SOLVING, CULTURAL HUMILITY AND AWARENESS, EMPATHY AND COMPASSION, ETHICAL RESPONSIBILITY, INGENUITY AND INNOVATION, RELIABILITY AND DEPENDABILITY, RESILIENCE AND ADAPTABILITY, SELF REFLECTION AND IMPROVEMENT, TEAMWORK AND LEADERSHIP.

Context, Roles & Responsibilities - 750 characters

Most Meaningful Experiences
From the list of experiences provided, identify up to 3 that you consider the most meaningful. Please describe why these were significant for you and how they impacted your journey.
(Please list the experience, why it was meaningful, and its personal impact on you.)

Impactful Experience

Please reflect on any challenges or hardships you have faced that influenced your journey toward residency. This could include personal, financial, or educational challenges, or experiences related to family or community background.

Challenges/Hardships
Have you encountered any significant challenges or obstacles that impacted your path to residency? If yes, please describe the challenges and how you overcame them.
(Include details about the nature of the challenge, how it affected you, and what you learned from the experience.)
Note:
If you feel this question does not apply to you or you're uncomfortable sharing, it is optional.

Hobbies & Interests

We would love to learn more about what you enjoy outside of your professional life.

Hobbies & Interests
Please provide details about your hobbies and interests. These can include personal, creative, recreational, or community-related activities.
(Briefly describe your hobbies or interests and how they contribute to your overall well-being or personal development.

Licenses and Certifications Application Template

State Medical Licenses

Please add an entry for any of your state medical licenses. Complete the required fields for each license.

State:
License Number:
Date Issued:
Expiration Date:

Additional Questions

Are you able to carry out the responsibilities of a resident or fellow in the specialties and at the specific training programs to which you are applying, including the functional requirements, cognitive requirements, interpersonal and communication requirements, and attendance requirements with or without reasonable accommodations?

Options: Yes / No / No Response

Has your medical license ever been suspended, revoked, or voluntarily terminated?

Options: Yes / No

Have you been named in a malpractice case?

Options: Yes / No

Is there anything in your past history that would limit your ability to be licensed or limit your ability to receive hospital privileges?
(Note: This section is not intended to solicit information about your health, disability, or family status.)

Options: Yes / No

Have you ever been convicted of a misdemeanor in the United States?

Options: Yes / No

Have you ever been convicted of a felony in the United States?

Options: Yes / No

Board Certifications

Are you Board Certified?

Options: Yes / No

If Yes:

Specialty:
Certifying Body:
Date Certified:
Expiration Date:

Other Certifications

Do you have any other medical or healthcare-related certifications?

Options: Yes / No

If Yes:

Certification:
Certifying Body:
Date Issued:
Expiration Date:

DEA Registration

Please enter your Drug Enforcement Administration (DEA) Registration number and the month and year of expiration.

DEA Registration Number:
Expiration Month/Year:

Publications Entry Template

Use this template to provide the necessary information about your publications when filling out applications.

Publication Type

Select from the options below:

Peer-Reviewed Journal Articles/Abstracts
Peer-Reviewed Book Chapter
Scientific Monograph
Poster Presentation
Oral Presentation
Peer-Reviewed Online Publication
Non-Peer Reviewed Online Publication
Other Articles

Publication Details

Online Publication Title (required)

Enter the title of the publication:
(255 characters max)

Author(s) (required)
URL (required)

Provide the URL link to the publication

Publication Date (required)

Enter the publication date in MM/YYYY format: