OB/GYN Residencies Will Stop Using the AAMC ERAS Application

On July 28, 2023, the Association of Professors of Gynecology and Obstetrics (APGO) announced a new application platform for obstetrics and gynecology (OB/GYN) residency applicants in the 2024–2025 application cycle. During that cycle, OB/GYN residency applicants will not use the Association of American Medical Colleges (AAMC) Electronic Residency Application Service (ERAS).

According to the APGO announcements, this new process is a collaborative effort by APGO, the American College of Obstetricians and Gynecologists (ACOG), and its Council on Resident Education in Obstetrics and Gynecology (CREOG). Using funding from the American Medical Association (AMA) Reimagining Residency grant program, OB/GYN education leaders have developed a new procedure to ensure that all residency applicants are comprehensively evaluated.

ACOG has partnered with Liaison International to develop a platform that includes application submissions, reviews, interview offers, interviews, and rank list submissions. Although completed details of the program have yet to be released, APGO boasts that the new application will benefit program directors, managers, and applicants.

APGO claims that the platform will be easier to use than the traditional ERAS system by streamlining recommendation collections and credentials in a mobile-friendly platform. However, the OB/GYN applicants will still be part of the National Residency Match Program, meaning that standard matching protocols will not change, but the application interface will.

The organization also notes that the new application will be significantly less expensive than traditional residency applications to help minimize the financial burden on OB/GYN residency applicants.

According to the AAMC, the first 10 ERAS program applications cost $99 for one specialty, and the following 10 applications cost $19 per program. For applications 21–30, each application is $23, and any application after 30 applications is $27 per submission. Residency applicants applying for multiple specialties must pay $99 for the first 10 applications in each specialty, and the payment hierarchy is specialty specific.

In addition to standard application fees, it costs $80 to transfer scores from the United States Medical Licensing Examination and $90 to submit Comprehensive Osteopathic Medical Licensing Examination scores. A complete overview of ERAS fees is available on the AAMC website.

The high price of medical education is no secret to clinicians and researchers and likely contributes to disparities in graduate medical education (GME). A 2022 research letter published in JAMA Network Open evaluating GME placement between 2018 and 2021 revealed that low-income students were less likely to place in a GME.

Additional insights showed that Black and Hispanic male and female students were significantly less likely to match to a GME program than their White male counterparts, highlighting other disparities in the GME application and acceptance system.

While it is unclear whether the new application platform will address these issues comprehensively, APGO emphasizes its commitment to holistic application review.

The announcement of the new platform shocked the AAMC, which typically runs the residency application process and is the manager of the ERAS system. A statement issued by the AAMC president and CEO, David J. Skorton, MD, and chief academic officer Alison J. Whelan, MD, noted, “We were surprised and dismayed by today’s announcement that the American College of Obstetricians and Gynecologists (ACOG) is launching a new residency application platform for the 2024–25 residency application cycle. While it is too early to fully understand the consequences of this development — intended and unintended — the AAMC remains committed to creating a fair and equitable process for learners, medical schools, and programs.”

The organization has been widely criticized for its exorbitant fees and disconnect from the medical community, and this statement was just another nail in the coffin. Across social media, medical students, residents, and physicians received the notice poorly, highlighting the negative undertones of the AAMC.

In a tweet, Ian Fields, MD, MCR, Residency Program Director for Oregan Health and Science University OB/GYN Residency, commented, “It is very concerning that the AAMC response to the OBGYN residency application announcement today doesn’t mention anything about equity, cost-savings, and efficiency. I think they know they’ve already lost. And I hope this is just the beginning.”

“To throw in that they have supported OBGYN in the midst of Dobbs is irrelevant and carries with it a veiled threatening undertone. AAMC needs better people managing their communications,” he continued.

As OB/GYN residency applications decline after the Dobbs decision, improving application accessibility may be a saving grace, widening the applicant pool and creating a diverse, prepared workforce despite ongoing reproductive health policy challenges. Although the OB/GYN residency applicants declined nationally by 5.2% between the 2021–2022 and 2022–2023 application cycle, states with abortion restrictions and bans saw a more significant decline in applicants at 6.4% and 10.5%, respectively.

Data from the AMA notes that 54.6% of residents continue practicing in the state they completed their GME. For abortion ban states, this means that coming years could significantly reduce practicing OB/GYN physicians, which could be disastrous for patients with high-risk pregnancies and birth complications. However, widening the applicant pool with a more accessible application may remedy that.

While the implications of this new residency application platform are not fully understood, this change, if successful, could set a precedent for other specialties and overhaul the residency application system altogether. Medical professionals and programs await additional details. APGO has provided the timeline below to outline design, training, and rollout efforts for the coming year.