How to Become a Doctor: Every Step to Residency (2026-2027)

The AAMC maps the premedical steps starting four or more years before medical school, and the NRMP sets the residency transition dates through your July 1 start of Graduate Medical Education (GME). High schoolers and college freshmen start at Step 1 below. Career changers enter at the postbaccalaureate or two-years-out mark, depending on how many science classes they still need. For the month-by-month schedule of your application year, see our Medical School Application Timeline (2027 Cycle).

Visual timeline graphic (Step 1 to Step 7): [Step 1: Premed or postbac prep (4+ years out)] -> [Step 2: MCAT and school list (2 years out)] -> [Step 3: AMCAS, AACOMAS, or TMDSAS (1 year out, May to spring)] -> [Step 4: Medical school interviews and offers (August to February)] -> [Step 5: Medical school and USMLE/COMLEX exams] -> [Step 6: Residency applications and NRMP Match (Sept to March)] -> [Step 7: Residency (3 to 7 years, starting July 1) and fellowship].

When you reach the interview stage for medical school or residency, Confetto runs AI mock interviews in MMI, traditional, and panel formats with follow-up questions on your answers. Start your free week.

Four or more years before medical school, the AAMC recommends meeting your campus prehealth advisor to finalize your fall schedule and sequence your required classes for medical school. If your college lacks an advisor, or if you have been away from school, both the AAMC and the American Association of Colleges of Osteopathic Medicine (AACOM) direct you to the National Association of Advisors for the Health Professions (NAAHP) for volunteer advisors.

Outside class, build relationships with faculty and mentors for future letters of evaluation, and continue clinical, volunteer, research, and leadership roles three years before matriculation. If you are changing careers after college or taking gap years, the AAMC advises discussing postbaccalaureate premedical programs and medically related employment with your advisor, and paying down credit card and undergraduate debt before medical school begins.

• Shadow and volunteer early: Use campus career services to find health care internships, paid clinical jobs, volunteer shifts, and physician shadowing.
• Keep an experience journal: The AAMC advises keeping a journal of your clinical, volunteer, shadowing, and research experiences starting four years out to reference for essays and interviews.
• Apply to summer programs: Consider the Summer Health Professions Education Program (SHPEP) and summer research or enrichment programs four and three years out.
• Track every college credit: AACOMAS requires official transcripts from every institution attended, including high school college-level courses, summer school, community college, military institutions, study abroad, and postbaccalaureate or graduate work.

Two years before entering medical school, meet with your prehealth advisor to decide whether to apply straight through or take gap years. That choice sets your Medical College Admission Test (MCAT) date.

Before registering for the MCAT or buying prep materials, check your eligibility for the AAMC Fee Assistance Program, which helps applicants who would find it very difficult or impossible to pay for the MCAT and AMCAS. Benefits are not retroactive. Do not register for the MCAT, buy MCAT Official Prep products, or submit AMCAS until your fee assistance request is approved or denied.

Next, review the AAMC's MCAT Essentials, the What's on the MCAT Exam outline, and the six-step Study Plan for the MCAT Exam using free and low-cost MCAT Official Prep resources. Leave calendar room to retake the exam if needed.

If you apply to osteopathic (DO) schools, the AAMC does not send MCAT scores to AACOMAS automatically. Log into the MCAT Score Reporting System and select the American Association of Colleges of Osteopathic Medicine Application Service as a recipient. Match your exact full name, date of birth, and eight-digit MCAT/AAMC ID on your AACOMAS application. AACOMAS takes about 10 to 12 days to process official electronic scores and rejects paper copies.

One year before medical school, you submit your primary application, official transcripts, and letters of evaluation, followed by school-specific secondary applications. Read our guide to MD vs DO degrees to decide whether to apply to allopathic schools, osteopathic schools, or both.

Most U.S. MD schools use the AAMC's centralized American Medical College Application Service (AMCAS) for first-year entering classes, while Texas schools use the Texas Medical and Dental Schools Application Service (TMDSAS). For Fall 2027 entry, the 2027 AMCAS application is open, with deadlines listed in the AMCAS Medical Schools and Deadlines search tool.

U.S. colleges of osteopathic medicine (COMs) use the AACOM Application Service (AACOMAS), with school requirements and deadlines in the Choose DO Explorer. Because DO schools review files, interview, and extend offers on a rolling basis, seats can fill before the final deadline. Apply early and have every registrar send official transcripts directly to the application service, as student copies and transfer credit listings are not accepted.

For the 2026-2027 AACOMAS cycle, the fee is $198 for the first designated college and $60 for each additional college. By our calculation from AACOM's 2026-2027 fee schedule, applying to 10 DO schools costs $738 in primary fees ($198 plus 9 times $60), and 15 schools costs $1,038 ($198 plus 14 times $60), before secondary fees. AACOMAS offers a limited number of $198 fee waivers that expire 14 days after approval if unused.

• Letters of evaluation: Request letters from faculty, advisors, and mentors one year out, and check your university's committee letter rules. Evaluators submit to AACOMAS electronically or via services in the Choose DO Explorer (such as Interfolio, VirtualEvals, or U.S. Mail).
• Early Decision Program (EDP): Participating DO schools offer an EDP where applicants apply to only one school and must attend if accepted.
• Secondary applications: Submit each school's supplemental application and fee after primary processing so your file is complete for interview review.

According to the AAMC, interview invitations typically start in late summer or early fall and can run into spring, with interviews most commonly held from August to February. AACOM notes that an invitation means your academic record has passed review, and interviews evaluate your listening and communication skills, ethics, social responsibility, and mission fit. Practice with our guide to common medical school interview questions.

Once offers arrive, follow acceptance protocols. AACOMAS traffic guidelines set maximum deposit deadlines by acceptance date. Starting April 1, DO schools report deposited students to AACOMAS. After May 1, AACOMAS reports candidates holding multiple acceptances, and schools may rescind offers after written notice. Before May 1, withdraw from all other DO schools and hold a seat at only one COM.

• Before interview day: Reread your application, personal statement, essays, and academic record, research the school's website and catalog, and ask your prehealth office for a mock interview.
• On interview day: AACOM advises arriving 10 to 15 minutes early in professional business attire and treating staff and students courteously, as they may comment on your conduct. Cancel promptly if needed.
• After the interview: Ask one or two questions connecting your background to the school, and send a handwritten thank-you note citing a specific detail from your visit.

In your final year of medical school, you apply to residency programs and register separately for the NRMP Main Residency Match. Per the NRMP's Introduction to the 2027 Main Residency Match and NRMP policy announcements, the AAMC's Electronic Residency Application Service (ERAS) is the most widely used application portal, while OB/GYN and Emergency Medicine programs use ResidencyCAS, and Plastic Surgery uses the American Council of Academic Plastic Surgeons (ACAPS) Residency Central Application.

After residency interviews, applicants and ACGME-accredited programs submit confidential Rank Order Lists (ROLs) in the NRMP's R3 system. The Main Residency Match covers all specialties except Ophthalmology and Urology. Under the Match Participation Agreement, programs cannot ask where else you applied or interviewed, how you used preference signals, or how you will rank them.

According to the NRMP Match Calendars and the 2027 NRMP applicant guide, 2027 Match registration opens on September 15 at 12:00 P.M. ET, the ResidencyCAS application deadline is September 17, and applications become available to programs on September 23. Standard NRMP registration closes on January 29 at 11:59 P.M. ET ($50 late fee after that date), ranking opens on February 1 at 12:00 P.M. ET, and the Rank Order List (ROL) Certification Deadline is March 3 at 9:00 P.M. ET. Match Week runs March 15 to 19, 2027: match status and the Supplemental Offer and Acceptance Program (SOAP) begin on Monday, March 15 at 10:00 A.M. ET, four SOAP offer rounds run on Thursday, March 18, and full Match Day results release on Friday, March 19 at 12:00 P.M. ET for residency training starting around July 1, 2027.

The NRMP algorithm is applicant-proposing, starting with your #1 ranked program and creating a tentative match if the program also ranked you and has an open spot or ranks you higher than a current tentative match. Per the NRMP's 2026 Main Residency Match report, 48,050 active applicants competed for 44,344 PGY-1 and PGY-2 positions across 6,809 program tracks, with a 93.5% overall position fill rate in the algorithm (41,482 filled, leaving 2,862 unfilled positions) and a 99.3% position fill rate including SOAP. Any two applicants can link their rank lists as a couple for an extra $45 per partner.

• NRMP fees: $85 standard fee (up to 20 unique program codes on your primary list and 20 on supplemental lists), $30 per extra code up to 300 ranks, plus $50 to $200 for lists of 100 to 300 ranks.
• Verification: Medical schools verify graduation eligibility for U.S. MD and DO seniors and graduates, and ECFMG (a division of Intealth) verifies International Medical Graduates (IMGs) by 9:00 p.m. ET on March 3, 2027.

Residency starts around July 1 after graduation. Under the Match Participation Agreement, your match is a binding commitment. As detailed in the NRMP's Introduction to the 2027 Main Residency Match and the NRMP Residency Applicants Guide, the NRMP groups Main Residency Match tracks into five program types, identified by the eighth character of the 9-to-11-character NRMP program code: Categorical (C) programs run 3 to 7 years starting in PGY-1 and lead to specialty board certification, Primary Care Categorical (M) programs offer categorical training in primary care Internal Medicine and Pediatrics, Preliminary (P) programs provide 1 year of prerequisite PGY-1 training, Advanced (A) programs run 3 to 4 years after preliminary training (entering PGY-2 in 2028 for the 2027 Match), and Reserved-Physician (R) tracks offer PGY-2 positions starting in 2027 for physicians with prior graduate medical education.

After residency, physicians seeking subspecialty training apply through the NRMP Specialties Matching Service (SMS). For the 2026 appointment year, the SMS ran 23 Fellowship Matches across 81 subspecialties (6,606 programs and 15,358 positions), filling 12,963 positions (84.4%) and placing 81.8% of the 15,846 fellowship applicants.

Whether you are preparing for your first medical school interview or a residency interview, Confetto lets you rehearse MMI stations, traditional one-on-ones, and panel interviews out loud with rubric-based feedback. Start your free week.

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• AAMC: Timeline for Application and Admission to Medical School
• AAMC: Apply to Medical School with the AMCAS Program
• AAMC: The Interview Timeline
• AACOM: Apply to Medical School (2026-2027 Key Dates)
• AACOM: The Application Process (AACOMAS Fees, Transcripts, and Traffic Guidelines)
• AACOM: Admissions Interview
• NRMP: Introduction to the 2027 Main Residency Match
• NRMP: Policy Announcement and FAQs on Application Services
• NRMP: Residency Applicants Guide
• NRMP: Match Calendars