US Navy Residency Application Blueprint

Navigating the USN Match Process

Last updated 10/2022

So you want to be an EM physician? Welcome to the family! Being in the military will provide a lot of unique experiences, but comes with its own unique challenges as well. The military residency match process is much different than its civilian counterpart, and certain details may change from year to year. So with a grain of salt taken, below is a step-by-step guide to help you navigate the yellow brick road that is the USN residency match process.

STEP 1: Choosing Your Program(s)

Decide which 1-2 residency program(s) you would like to do an audition rotation with, and which programs you just want to interview with. Available programs and sites may be reviewed on the USN Accessions webpage here:

  • Pro-tip: Review the most recent BUMEDNOTE 1524 as well, for a list of available PGY-1 sites and specialties. The notices are annually updated and can be found online using your favorite search engine.
  • Pro-tip: Audition rotations are typically 4-week rotations at one site, so emphasize spending time at the program(s) or location(s) you are most interested in.
  • Pro-tip: The Navy fiscal year starts Oct 1st. Since you must execute one set of active duty for training (ADT) orders per fiscal year, consider scheduling two active duty audition rotations during your fourth year; one before the Oct 1 fiscal year change and one after. *** many people know this trick so October rotations fill up fast.
  • Pro-tip: You should attempt to interview with every residency you apply to, even if it is only over the phone. If you are in the area of your program before the interview season really starts, consider reaching out and interviewing early, especially if you are unavailable in the fall due to deployments or travel.
  • Pro-tip: Apply as early as you can, even if it is the fall of your third year. Rather to be too early than too late and not get a shot at spending time at the institution of your choice.

STEP 2: Set Up Your Audition Rotation(s)

Once you decide which residency program(s) you want to audition with, look up the available dates that that program will be accepting auditioning students and compare it to your personal schedule. Request your audition rotation(s) before applying for ADT. You do not want to be the student who has their ADT confirmed before an audition slot is confirmed. To set up an audition rotation, do your homework and explore that program’s website for site-specific requirements. Reach out to the contact list in the residency catalog with specific questions.

  • Pro-tip: USN audition rotation dates should be posted on that program’s website. Contact that program’s coordinator if available dates are not listed.
  • Pro-tip: Spots for audition rotations are typically offered on a first-come-first-served basis by submitting proper documentation via email to that program’s coordinator starting the morning of December 1 at 12:00am in that program’s timezone. Meaning if you live in a different timezone than your desired rotation, be sure that you don’t accidentally email the coordinator too early (and risk having your request ignored) or too late (and risk having all the spots already filled).

STEP 3: Set Up Your ADT

Once your audition rotation spot has been confirmed by your desired residency program, it is time to set up your ADT. Do NOT request your ADT dates before your audition rotation spot has been confirmed.

  • Pro-tip: Follow the links below to review the USN Accessions webpage regarding ADT clerkship scheduling and requests:
  • Pro-tip: If your ADT is not approved, you will be notified and informed on how you can resolve whatever the issue may be.

STEP 4: Set Up an Interview with Your Desired Program(s)

Before you arrive for your audition rotation, YOU are responsible for confirming that an interview will be conducted while you are on site. Site-specific instructions to coordinate your interview will be included in the confirmation email you receive from each site. If you are not able to attend an in-person interview, there are options for phone interviews.

  • Pro-tip: contact information for each program coordinator can be found through the link below. Refer to this webpage for specifics regarding each site’s interview scheduling.

STEP 5: Begin the Military Match Application Process

As you approach your fourth year, you will receive an email from HPSP leadership with specific instructions about your residency application timeline. Details are also included in BUMEDNOTE 1524, updated annually. Deadlines for the military match are typically a few weeks or months earlier than similar civilian deadlines. Be sure to familiarize yourself with your match year’s deadlines to maximize your chances for success.

MODS, or the Medical Operation Data System, is the service used to submit your military residency application. Start the MODS residency application process as soon as possible, especially if you are seriously considering the civilian residency match — deadlines vary between the military and civilian match, and can sneak up on you very quickly. The last thing you want is to accidentally sabotage your own residency application should any last-minute issues arise.

  • Pro-tip: MODS is only available through CAC-enabled computers. If you are not near a base or have CAC access on your personal computer, you will likely complete and submit a paper application. You will receive more detailed instructions via email from HPSP leadership when you become a fourth-year student, as well as in the BUMEDNOTE 1524 for your application cohort.

There are a couple different options of how you can do residency or intern year. The first is you could get an active duty slot, which means that you are paid by the military and don’t incur extra duty time since you are active. You could be civilian deferred, meaning that you are not paid by the military and would be considered inactive. Lastly, you could be civilian sponsored, meaning that you are paid by the military but not considered to be active, so you do incur extra duty time.

STEP 6: Begin the Civilian Match Process

Specific instruction regarding the timeline for HPSP students applying to the civilian residency match may be found in each year’s BUMEDNOTE1524, with HPSP-specific advice found at the bottom of this webpage:

Step 6.5: Have a backup plan

So the huge fear of going into the process is that you won’t match, and your dreams won’t come true. Take a deep breath. Many of us do intern years and go back into the match process and get into good programs. Military EM is a competitive field, and sometimes it just doesn’t work out the first time around. This is why it is important to always go into this process with backup plans. Make sure that you are applying to civilian and military intern years, of which there are several different options (IM, surgery, or TY). IM and surgery years offer great opportunities, but just be aware that you will not have as much free time to do match stuff as you will with a TY, or transitional year. With a TY, they are built for residents that are moving on to other residencies, and will naturally have much more selective time built in. This time you can take to do additional audition rotations at the residencies you are trying to get into.

  • Pro-tip: DO NOT WAIT until you find out what the results of the match are in December (which FYI is when it is). If you wait, then what you will run into is that as you apply for these intern programs they will all be full, and you’ll freak out. Play it safe and have a backup plan in place.

In addition to the three kinds of intern years, military residents also have the option to do GMO (General Medical Officer) tours, including some military unique opportunities such as dive and flight medicine. This can become your career, or you can use it to boost your points and apply to an EM residency. If you don’t match the first time around you have one additional shot to match, and if you do not you will automatically be placed into a GMO slot.

STEP 7: Receive and Execute Your ADT Orders

You should receive your ADT orders in PDF format at least 10 days prior to your ADT start date. Contact if you have not received your orders by that time.

STEP 8: Letters of Recommendation

The Standardized Letter of Evaluation (or SLOE) is a special letter of recommendation that is required by EM residencies. Information about the SLOE is available on the CORD website here: As well as an EMRA breakdown of the SLOE and how to make yours stand out:


  • Pro-tip: Your goal should be to have a minimum of two recommendation letters or SLOEs included in your application package, preferably from military physicians in the field you are applying for.

STEP 9: Consider Attending the USUHS Medical Specialty Night (or other Site- Specific Open House)

Each year when military residency program directors meet to discuss the military match applicants, the Uniformed Services University (USUHS) hosts a Medical Specialty Night open house on their campus in Bethesda, MD where students can meet-and-greet with these PDs. While the specific date varies from year to year, the event is typically held on a Tuesday evening in mid- to late November. Contact to inquire about the USUHS Medical Specialty Night if you have not received information from HPSP leadership by October 15th each year.

Each individual training site (NMCP, NMCSD, WRNNMC Bethesda) also occasionally hosts Open House events for the programs at their site. This may also be an opportunity for you to explore location(s) and program(s) you are considering and begin making a name for yourself. Contact the program coordinator for the site(s) you are interested in to see if they have any upcoming events, or inquire through the HPSP pipeline by emailing

STEP 10: The Waiting Game

Now that you have submitted your applications, completed your audition rotations, and survived your interviews, it is time to wait for a decision. After the final submission deadline passes and all applicant interviews are performed, the Program Directors get together and spend the better part of 6-8 weeks evaluating, discussing, and matching each applicant to their respective program. Each PD puts together their order of merit list of candidates and turns it into their GME offices. These lists are then presented to a general officer board who determine the final lists. Nothing is official until the release day in mid-December. Even the PDs do not officially know the final selection board results until that fateful mid-December date.

The Elusive Point System and Scoring Sheet

When your application is reviewed by the Joint Service Graduate Medical Education Selection Board (JSGMESB), it is scored using a standardized point system. A total of three programs will score your application, and the programs that will review your specific application are chosen at random. The scoring is weighted heavily towards people who have spent time in the military already, either with prior service or as a GMO, FS, UMO, etc. This is designed to encourage participation in GMO tours. The good news for you is that medical students are typically compared to other medical students (for PGY-1 positions) and the GMOs compete against other GMOs (for PGY-2 and beyond). This is subject to change based on the needs of the Services.

The basics of the point system are outlined below:

  • 5 Points Available: First and Second years of medical school
    • 0-2 points for first-year grades
    • 0-3 points for second-year grades and board scores
  • 5 Points Available: Potential for success as a military officer
    • 0-5 points based on interviews, performance on rotations, general impression, previous things such as leadership and research
  • Currently an Intern (PGY-1)?
    • 0-3 points available based on performance during intern year
  • Already completed Intern year at the time of application?
    • 0-5 points available based on performance
  • Served as a General Medical Officer, Flight Surgeon or Undersea Medical Officer?
    • 0-5 points available based on performance

Best of luck with your residency application! You got this!

Related Content

Feb 02, 2020

US Navy Residency Application Blueprint

The military residency match process is much different than its civilian counterpart, and certain details may change from year to year. So with a grain of salt taken, below is a step-by-step guide to help you navigate the yellow brick road that is the USN residency match process.

Jan 29, 2020

Navy EM Residency Programs

Current US Navy Force Emergency Medicine Residency Programs

Jan 28, 2020

United States Navy Medical Service

Check out a few resources and helpful hints to help all new officers and aspiring HPSP’ers fulfill their requirements and learn what it takes to be an officer in the United States Navy.