Reader Questions: Do I have to rank civilian deferral?

Hey, first off, thank you for your site and sharing info. I am currently a third year medical student in AFHPSP as well. And I’m not really interested in civilian deferred position. So if I am interested in EM and FM or IM, can I put multiple EM as primary, FM or IM and secondary and not put civilian deferment in my rank list? Also do I have to apply through ERAS as well?

This is a common question! The rules of the match vary ever so slightly from one branch to another, and I can only speak for the details of the Air Force process. Hopefully others can speak to the Army and Navy process.

In the Air Force, as of the year when I applied, if you apply to a particular specialty, then you must rank every location at which that specialty is offered. This includes civilian deferral, if civilian deferral is listed on the HPERB list for that year. (More on HPERB here.) You can rank it last, but you do have to rank it. That being said, the form only had 6 slots, and in 2009 the formal guidance said that you could rank up to 6 locations. In my specialty, there were only 6 options to rank. A colleague wrote in the rest of the locations on the paper form. Your mileage may vary.

You can rank two specialties by using the “second choice form” but you can’t rank more than two specialties. The way the military match works, you are selected for a specialty first and a location second. Unlike the civilian (NRMP) match, where each program (specialty-location pair) is treated independently, in the military match you must rank all locations within a specialty together. So, for example, you could submit this rank list:

First-choice specialty: EM
Location A – EM
Location B – EM
Second-choice specialty: IM
Location A – IM
Location B – IM
Civilian Deferred – IM

But you couldn’t do this:

Location A – EM
Location A – IM
Location B – EM
Location B – IM

Yes, you need to apply to ERAS. In fact, you need to apply to ERAS for both categorical training (i.e. EM residency) in case you are assigned to civilian deferral in your specialty, and to a PGY-1 only, in case you do not match to your chosen specialty in the military match. If you don’t match to your chosen specialty in the military match, you will be assigned to complete a PGY-1 only in IM, general surgery, or transitional year. You could match to a military program or to “civilian PGY-1 only,” which means you need to go get a civilian PGY-1 only. You can “gamble” and wait to apply for civilian PGY-1 only spots until the results of the military match come out. This may reduce your odds of getting the PGY-1 only that you want if you have to go through ERAS for a civilian PGY-1 only.

The good news? The Air Force will reimburse you for some of your ERAS costs. As of 2014, they would reimburse you for up to $300 in ERAS fees. So go wild! Spend $300 of someone else’s money to cover your rear in case you don’t get the military program you want.

Does that answer all of your questions about JSGME rank lists? If not, please leave a comment below and let’s keep talking about it! Good luck!

Indy