How much does it cost to apply to residency?

Dear Applicant,

Applying to residency is billed by at least three organizations. The AAMC bills per program through ERAS. The NRMP bills you to enter the Match. International graduates pay ECFMG for the token that opens MyERAS at all. So "how much does it cost" depends on how you count, and the counting rule is the part worth understanding.

ERAS and the Match are separate bills. AAMC says so directly: "Registration with the ERAS program does not register you for any established match." NRMP, from its side: "You must register for both the NRMP and the application service or process required by the program."

AAMC's "Fees for the 2027 ERAS Season" page carries a two-row residency table. Programs per specialty, 1-30: $11 each. Programs per specialty, 31 or more: $30 each.

The sentence under the table is the one to memorize: "Cost is per specialty; pricing resets with each additional specialty."

AAMC gives three worked examples:

Example 1: 30 Emergency Medicine programs [30 x $11] = $330.

Example 2: 43 Internal Medicine programs [(30 X $11) + (13 X $30)] + 7 Radiology programs [7 X $11] = $797.

Example 3: 32 Internal Medicine programs [(30 x $11) + (2 x $30)] + 32 Emergency Medicine programs [(30 x $11) + (2 x $30)] = $780.

MyERAS calculates the total and takes Visa, MasterCard, American Express, or Discover.

Compare Examples 2 and 3. Example 2 adds up to 50 applications (43 plus 7) for $797. Example 3 adds up to 64 applications (32 plus 32) for $780. More applications, less money.

Within one specialty, application 30 costs $11, application 31 costs $30, and every program after it stays at $30. But the counter belongs to the specialty, not to you. The first program in a second specialty is back at $11.

Run the published tiers on 60 programs. Sixty in one specialty is $330 for the first 30 plus $900 for the next 30, or $1,230. The same 60 split 30 and 30 across two specialties is $660.

None of this says how many programs to apply to or in which specialties; that conversation belongs with your advisor or dean's office. It does say that "cost per application" is not one number. The total moves in a step, not a slope, at 30 per specialty.

USMLE transcript. This is new for 2027. The USMLE program calls it "centralizing all USMLE transcript requests with FSMB," and FSMB "will begin processing all transcript requests" for the 2027 ERAS season "starting on June 4, 2026." The cost "will be $70. This is a one-time fee per residency application cycle." Requests and payment are submitted "through FSMB's USMLE portal," and the request then finishes inside MyERAS, under "Initiate Score Retrieval" in the Additional Documents section. AAMC's residency fee page lists the same figure: "USMLE Transcript: $70 (assessed once per season)."

COMLEX-USA transcript. AAMC lists "COMLEX-USA Transcript: $80 (assessed once per season)."

ERAS token. Every applicant registers for MyERAS with a token from a Designated Dean's Office, and "An ERAS token can only be used once to register." For US MD and DO seniors and graduates, that office is the medical school of graduation. For international medical graduates it is ECFMG, which charges "a $185 non-refundable fee for this service," due at the time of request and paid via MyIntealth. One token covers the season: "you can use that one Token to apply to as many specialties and programs as you want during the ERAS season."

Refunds. "The ERAS system does not offer refunds for any reason." AAMC's reasoning: "Once you apply to a program and submit payment through the MyERAS portal, service has been rendered and your application has been delivered."

A guarantee the program is taking applications. "Refunds will not be given for applications sent to nonparticipating programs." AAMC adds that "it is your responsibility to confirm that you meet all eligibility requirements and program deadlines."

NRMP's Match Fees page lists the current applicant fees. "Standard Registration Fee: $85 for Main Residency Match." That fee "includes the listing of up to 20 unique NRMP program codes on the primary rank order list and up to 20 unique NRMP codes on all supplemental rank order lists combined."

Past that: "For each NRMP program code ranked over 20, NRMP charges an extra rank fee of $30 per program code up to the maximum of 300 ranks." Lists of 100 or more ranks carry a further length fee, starting at $50 for 100-150 ranks. Couples "pay an additional $45 per partner."

Two timing rules matter more than the amounts. "The extra rank fee and the length of rank order list fee are due immediately upon certifying the rank order lists." And: "Lists that have been certified with extra fees cannot be modified later with the intent to remove extra fees." The refund line: "ALL Match fees are non-refundable."

Unpaid fees have teeth: "Applicants with outstanding fees will not be able to enter rank order lists or be ranked by programs until all fees have been paid in full."

NRMP's 2027 applicant calendar puts Registration Opens at Sep 15, 12:00 PM EDT, and the Standard Registration Deadline at Jan 29, 11:59 PM EST. "There is a $50 additional fee for registration after January 29." Late registration runs to Mar 03, 09:00 PM EST, the same moment as the Rank Order List Certification Deadline. The calendar carries a separate Registration Deadline entry at that date and time, labeled "Applicant late registration deadline for the Match and SOAP."

Add the $50 late fee to the $85 standard fee and registering after January 29 costs $135.

Liaison's Quick Start Guide says ResidencyCAS "streamlines the application process for programs." That guide, which dates itself to a June 1, 2026 applicant webinar, addresses "Obstetrics and Gynecology residency programs" and "Emergency Medicine and EM Combined programs" by name, and ECFMG points applicants to "certain residency specialties, including Emergency Medicine, and Obstetrics and Gynecology" toward ResidencyCAS support.

Liaison's fee page lists a schedule that is also "calculated separately for each specialty": $99 total for 1-18 programs, $18 per program from 19 to 30, and $23 per program at 31 or more. The $99 row carries a footnote: "Special pricing of $10 per program will be given to applicants applying to 9 or fewer programs overall, such as within a combined specialty." Its example: 20 OB/GYN plus 20 emergency medicine programs totals $270. The page's text carries no cycle label, and the Excel calculator it links to is a file named ResidencyCAS-Fee-Calculator-2025_1.xlsx.

Alex