2027 ERAS Changes: Publications to Scholarly Work

Residency applications just changed, and many are calling it a win for applicants. They’re wrong.

The change aims to improve how an applicant’s research is evaluated, but it’s not enough to slow down an arms race that’s already well underway. We’ll show you exactly why, what the data actually says, and what this means for your strategy going into this cycle and beyond.

The Research Arms Race

To understand any of this, you have to go back to when Step 1 went pass/fail.

Without Step 1 scores, programs needed another filter for applicants, making the other hard metrics, including Step 2 CK and research items, all the more important.

The average number of research items for successful neurosurgery applicants went from 23.4 to 25.5 between 2020 and 2022. Dermatology moved from 19.0 to 20.9. Orthopedic surgery crept from 14.3 to 16.5. While meaningful, the increases are relatively slight.

Then Step 1 went pass/fail, and the pace changed dramatically. By 2024, neurosurgery had jumped to 37.4, an increase of nearly 12 items in just two years compared to only 2 in the two years before. Dermatology went from 20.9 to 27.7. Orthopedic surgery from 16.5 to 23.8.

We expect these numbers to jump again when the new 2026 data drops this summer. You can track how research numbers have moved by specialty at SpecialtyRank.com.

While the arms race was already underway before Step 1 went pass/fail, that change poured fuel on a fire that was already burning. The AAMC’s response was to redesign the section to prioritize quality over quantity.

What Changed

The Publications section of the residency application has been replaced by Scholarly Work. The categories are cleaner, and you can only report work submitted to peer-reviewed entities, like journal articles, book chapters, journal abstracts, oral presentations, and poster presentations. You can star up to three items as your most meaningful, and first authorship is now visible directly in the application.

The change comes after pressure from programs that say long publication lists without surrounding context don’t tell the full story. One research project could appear in four separate forms: an abstract, a poster, an oral presentation, and a manuscript. The new section tries to force a narrative around what you did, your role, and how it connects to your future career.

The change aims to slow the rapid increase in the average number of research items across all specialties, especially in the most competitive areas like neurosurgery, where the average has already exceeded 37.

But renaming a section doesn’t change what programs are looking for. 

Will This Change Actually Do Anything?

In competitive specialties, volume plus quality has always been the expectation, and a structural update to how items are displayed won’t shift that.

A program director reviewing hundreds of applications is still going to notice the difference between someone with ten publications and someone with fifty poster presentations and nothing in print. The star feature for most meaningful work adds some extra information, but it sits on top of the underlying count rather than replacing it.

The second issue is that limiting the section to peer-reviewed work might not reduce pressure on applicants at all. It could actually concentrate pressure specifically onto peer-reviewed output, since that’s now the only thing visible in this section.

Students who invest real time in op-eds, policy work, advocacy, or medical humanities lose that visibility. It gets shuffled to another part of the application where program directors are much less likely to look.

Rather than slowing the arms race down, it makes things harder for certain applicants. And this hasn’t gone unnoticed. 

The AMA formally responded at its 2025 Interim Meeting by adopting a policy calling for equitable consideration of research, advocacy, service, teaching, and mentorship in residency selection.

But to be clear, that’s not a rule. Programs aren’t required to do anything differently.

The largest physician organization in the country is going on record to say that research is over-indexed and that these changes won’t meaningfully fix that. Which is a pretty major red flag. 

Raising the bar on research also intensifies an existing fairness problem. Students at large, well-funded universities have access to resources and connections that students at smaller or less prestigious schools don’t. Redesigning the section doesn’t fix that. If anything, putting more emphasis on peer-reviewed output makes those disparities worse.

Medical school is still only four years without a research gap year. The curriculum hasn’t expanded to accommodate research as the arms race intensifies. Something else has to give, whether that’s clinical time, studying, or the three pillars of health: sleep, nutrition, and exercise.

Competitive programs have been running their own internal scoring systems for years. Publications outweigh abstracts and presentations, oral presentations rank above posters, and first-author credit carries more weight than secondary authorship. Plus, the journal impact factor gets built into the score.

Programs built these systems precisely because they needed a way to separate applicants who had done real work from those who had padded the list without producing anything substantial.

The ERAS change didn’t create that problem or solve it. It merely standardized something programs were already doing on their own.

The Counterarguments

The AAMC’s position is that program directors asked for this change. The old structure made it hard to understand an applicant’s real relationship to their research. The new one requires them to describe their role, their contribution, and what the project was actually doing. In theory, programs get a clearer picture of who did meaningful work versus who was the eleventh author on a paper they barely touched.

Optimists might say the most meaningful designation could gradually shift how applicants approach research. Over a few cycles, students could start building for quality rather than volume, since the application now rewards it, and programs could recalibrate accordingly.

Some people are even suggesting that the average number of research items could drop. But this is highly unlikely. For any of that to happen, program directors would have to fundamentally change how they review applicants.

There are still more applicants than spots. They’re still looking for every signal they can find to separate one strong candidate from another. Students will adapt to whatever the form looks like and compete just as hard within it.

What This Means for Premeds

Research is what we call the superpower extracurricular because it’s the only activity that follows you beyond college. Every publication, abstract, and presentation you earn as an undergrad goes on your residency application, too. That’s true of nothing else you do in college.

If you’re not targeting a competitive specialty yet, that can change. 72% of premeds change their minds or aren’t sure of their specialty choice when entering med school. Give yourself optionality because there’s a notable chance you’ll change your choice as you’re exposed to what different career paths are actually like.

Clinical research is the more efficient path for most premeds. You’re doing chart reviews and database analyses, and working closer to the clinical environment than the bench. The output timeline is faster, and you’re less likely to spend two years invested in a single project that may not yield authorship.

Basic science research can sometimes be more impressive when it works, but it’s higher risk. The most effective strategy for most premeds is clinical research that produces multiple items over a sustained period.

But this strategy only works if you can get in the door and make yourself worth keeping around. The problem most premeds make is simply finding a lab, showing up, and waiting to be told what to do.

The PI you’re working with is constantly running a mental calculation: do I spend 90 minutes teaching this student, or do I just do it myself in 30? If you’re not actively moving things forward, you already know how that math works out.

The result is a weaker letter of recommendation and a lower research count. Not because you didn’t work hard, but because showing up isn’t the same as adding value. Taking agency over the research process and understanding how to move projects forward are what actually change your trajectory. 

Ideally, begin reaching out after a few months into your freshman year. Getting up to speed in a lab takes time, and longitudinal commitment is what programs actually value. A 10-20% response rate from cold outreach is normal, so don’t be easily discouraged. Send more emails than you think you need to.

To make it easier, use our free research email outreach template.

What This Means for Med Students

In 2024, unmatched applicants actually averaged more research items than matched ones: 11 versus 10 across all specialties. This shows that volume alone was never the whole story.

What that means in practice is aiming for medium-to-high quality research at volume. And to be clear about what that means: it doesn’t have to change the world. Nobody expects you to redefine how the medical system treats patients. But it does need to be substantive. A long list of case reports and narrative literature reviews isn’t going to move the needle the way you think it will.

Narrative literature reviews are a different animal from systematic reviews, and programs know the difference. Deep involvement in solid work, with first-author credit and something real to say about your contribution, is a stronger position than a padded list of loosely credited items.

If you’re in medical school, start sooner than you think you need to. Pick something in your target specialty and try to own a real piece of the project.

Even if you’re not currently interested in a competitive specialty, that can change as you get more exposure. Leave your options open.

When the 2026 data drops this summer, research item averages will be higher again. But that won’t tell us whether this change worked.

The Scholarly Work section doesn’t even take effect until this June, meaning the first cycle it applies to is 2026 applicants matching in 2027. That means we won’t have data that reflects its impact until 2028 at the earliest. But we don’t think the numbers will go anywhere but up. 

Years of escalating research requirements have pushed students toward chasing publications that have little to do with becoming a good physician. The AAMC knows this. That’s not the disagreement.

The disagreement is whether restructuring how items are displayed changes the incentives that created the problem. It doesn’t. There are still more applicants than spots. Programs are still looking for every signal they can find. Students will adapt and compete just as hard within whatever structure exists.

The Playbook Hasn’t Changed

Research requirements will keep climbing regardless of what the ERAS section looks like. The students who match into competitive specialties start early, add real value, and build a record that speaks for itself.

If you want a step-by-step system for doing exactly that, from finding the right lab to getting your name on a publication, our Ultimate Research Course covers it all.