2026 ERAS Residency Application Changes

The 2026 ERAS cycle is introducing significant changes to residency applications. For some applicants, this means more essays, while for others, it means changes in the signaling process.

Ultimately, for current fourth-year medical students preparing for the match, this could mean adjusting your ERAS strategy to optimize your chances of matching at your dream program. Understanding these changes will ensure nothing slips through the cracks on your application.

1 | Thalamus Integration for Interview Scheduling

The first major change is the AAMC and Thalamus establishing a partnership to integrate their entirely separate interviewing platforms into one centralized platform.

Historically, Thalamus was used to schedule interviews and, in some cases, conduct online residency interviews within the platform. For students, this was confusing, as it meant logging into two separate programs: one to submit applications and another to select interview times.

Having both programs communicate with one another will prevent confusion and significantly streamline the entire process of applying to residency programs.

2 | Program Signal Statements

This is a pilot program for applicants to anesthesiology and plastic surgery-integrated. Essentially, ERAS is trialing the “Why Us” essays that are part of medical school applications. Now, anesthesia and plastic surgery residency applicants will be able to provide more context and details on why they are choosing to signal this program.

Although more details about this pilot program are not publicly available, you can expect a brief description for each signal, vastly different from the traditional and longer “Why Us” essays.

Overall, for most applicants, this represents a significant improvement, enabling students with specific reasons for pursuing residency at a particular program to express their interest through their initial application. In the past, applicants could only express these specific reasons during an interview, which was not guaranteed.

3 | New Specialty-Specific Questions

New specialty-specific questions are another interesting change for the 2026 ERAS application. For students applying to anesthesiology, neurosurgery, or plastic surgery-integrated programs, applicants will need to complete several additional “specialty-specific questions.”

These questions allow applicants to demonstrate why they are a good fit for a particular field and highlight relevant experiences. Additionally, it will enable the personal statement to be focused on you, the applicant. Ultimately, most applicants are excited about this change, and many medical educators believe every specialty could eventually adopt it.

The major cons are for applicants who are dual applying with anesthesiology as their backup, which is common for those who apply for surgical subspecialties. Realistically, very few people are dual-applying with plastics or neurosurgery as their backup specialty.

For these applicants, the specialty-specific questions could be a headache as it will take time to craft meaningful, well-polished essays. If the essays are of poor quality, it could draw attention to the fact that you are dual applying, which, for many program directors, means your application will be automatically rejected.

For anesthesiology, here are the specialty-specific questions:

• Describe a time when you faced adversity, how you overcame it, and any lessons learned from it.
• Describe a situation in which you would have made a different decision that might have led to a better outcome.
• Describe your ideal career as an attending.

For neurosurgery, the specialty-specific questions are:

• Describe a time when you had to make a quick decision. What did you consider when making the decision? Who did you consult or not, and why?
• Describe a specific situation where you received negative feedback about your performance. How did you adjust your behavior? What did you learn from this situation?
• Describe a specific situation when your workload was overwhelming. What specific actions did you take to manage your workload? What was the outcome?

For plastic surgery-integrated programs, the questions are:

• Describe a specific situation when a team you were on had to collaborate to achieve an outcome, and there was a disagreement. How did you specifically contribute to the solution?
• Describe a specific situation where you experienced a setback. How did you overcome this challenge?
• Describe a time when you had to make an important decision quickly. What did you consider when making the decision?

4 | Geographic Preferences Opt Out Option (Pilot)

Another pilot change AAMC is making is allowing otolaryngology (ENT) and orthopedic surgery applicants the option to “Opt Out” of picking a geographic preference.

The current NRMP data powerfully demonstrate that when an applicant applies a particular geographic signal, they are significantly more likely to receive an interview from programs in that region. They are much less likely to receive interviews from any programs outside of that region.

Using this feature may disadvantage applicants, as it will be unclear to the programs whether they would be willing to match in that region.

For example, let’s say a hypothetical orthopedic surgery program in Chicago, IL, receives 20 applications and can only interview five people. Of those 20 applicants, 10 of them geographically signaled that region, five of them geographically signaled a different region, and the remaining five chose to opt out of geographically signally any region.

Realistically speaking, this program is primarily interested in the 10 applications that are outright saying they would be thrilled to live in Chicago, as opposed to the others who have either a neutral or negative desire to be in that area.

5 | New “Hometown(s)” Section (Pilot)

The “Hometown” feature is a long-requested change that applicants have been asking for for decades.

For example, suppose you are a medical student from Tennessee attending medical school in New York. In that case, there are only a couple of places on your application where you can mention your Tennessee connection.

On paper, this makes it difficult to highlight your connection to your home state, thus making it harder for you to match back to where you’re from, if that’s your goal for residency.

By creating a space for students to select places they have “currently or previously lived and feel strong ties or sense of belonging to,” it will make it much more likely for students to match back to where they grew up.

Among the 2026 ERAS applicants, this is by far one of the most popular changes, and for many students who were only accepted to one medical school far from their home, this is a significant change.

6 | Updates to the Education and Timeline Sections

The AAMC has announced that it is also making minor changes to the education section.

For example, they renamed the “Interruptions and Extensions” section to “Interruptions or Extensions” and are allowing applicants to include non-ACGME-accredited programs, which is only applicable for a tiny minority of applicants who are current residents looking to switch fields.

One thing that definitely hasn’t changed is the need to stay ahead of your residency application deadlines. The best residency application in the world won’t make any difference if it’s late.

Use our Residency Application Timeline and Month-by-Month Schedule to stay on track and ahead of deadlines.