September marks the beginning of the 2019 residency application cycle. Yes, after much research, prospective 2019 medical school graduates can finally begin applying to residency programs through the Electronic Residency Application Service (ERAS). The time- and cash-consuming application process, however, is far from over.

How big is the cost of applying to residency? Let’s do the math.

Related Coverage Here's how many residency programs med students really apply to

Calculating application fees

ERAS sends applications, letters of recommendation, transcripts and other credentials to the programs in which an applicant is interested. The cost of submitting applications is tiered based on the number of programs a medical student applies to per specialty.

A study using a sample size of 1,376 students from 20 medical schools for the 2014 Match found that students applied to an average of 36.4 programs. That number varies significantly depending on specialty. Based on this year’s ERAS pricing, if a student applied to 36 programs in the same specialty, the cost of applications would be $575. If those applications were spread out over a number of specialties, however, the cost could be lower.

Additionally, after interviews, an applicant will be required to pay fees to participate in the National Resident Matching Program. The standard registration fee for matches in 2018–19 is $85. You will also have to pay a fee to send your United States Medical Licensing Examination transcript to residency programs.

Who spends the most?

In that aforementioned 2014 study, only 8.6 percent of students spent more than $7,000 on residency interviews. Adjusted for inflation, according to the U.S. Bureau of Labor Statistics, $7,000 in 2014 has the same buying power as $7,540,84 today. Conversely, on the low end, 25.7 percent of medical students interviewing for family medicine residencies spent less than $1,000 in 2014.

The study—the most recent comprehensive overview of the cost of residency interviews across all specialties—states that “almost 20 percent of surgery applicants spent more than $7,000, and surgery applicants spent more than those applying to other specialties,” according to the study.

One potential explanation for this drastic gap in spending: “[Students] applying for residencies perceived to be hard to obtain, such as surgical specialties, were more likely to view the fourth year as a time to maximize the likelihood of matching in their residency of choice,” the study authors noted. “In fact, surgery applicants applied to more residency programs, completed more away [or audition rotations] or auditions, and spent more money on the interview process than applicants in almost every other specialty.”

For medical students participating in the Couples Match, the study also found, “the cost to interview was significantly higher” than for those who did not participate in that process, possibly because maximizing the likelihood of a couple matching in the same geographic area resulted in more travel for interviews.

How to save

The more you interview, the more you are going to spend. But you can save some money by following a these tips.

Interview with multiple programs in the same city. This will help you save on lodging, travel and meals. A few Chicago-based emergency medicine programs are even working in tandem to make the logistics of multiple interviews easier.

FREIDA™—a recently revamped comprehensive AMA tool that captures data on more than 11,000 residency and fellowship programs accredited by the Accreditation Council on Graduate Medical Education—offers over 35 filters to sort programs by location, program type, application information, demographics, benefits, special tracks and more to help applicants find all of the programs available within their desired specialty throughout the country.

Use your networks. That means staying with friends or family when possible. You also might consider working through your medical school or undergraduate school’s alumni office or social networking groups to see whether any alumni who live in the area would be able to host you.

Make the most of your miles and perks. Sticking with one airline, if possible, will allow you to accumulate the most frequent-flyer miles, especially if you acquire a credit card with a sign-up bonus that allows for the accumulation of miles on everyday purchases. It’s also worth keeping an eye out for discounts.

AMA members, for instance, can save on car rentals through a number of vendors, including Hertz, Thrifty and Dollar.