ResidencyCAS for IMGs 2027: EM & OB-GYN Guide

Fast answer

ResidencyCAS is the 2027 residency application service used for Emergency Medicine and Obstetrics and Gynecology. An IMG does not open the application through a medical school invitation or an ECFMG ERAS Token. The IMG first completes ECFMG's Residency Application Support Form, pays the applicable support fee, and waits for ECFMG to authorize access.

For the 2026–2027 cycle, ECFMG began sending IMG access links June 24, 2026. Applicants can request official exam scores beginning August 24, submit beginning September 2, and should submit by September 17 at 11:59 p.m. Eastern. Programs begin viewing applications September 23 at 9:00 a.m. Eastern.

The greatest risk is treating ResidencyCAS like a different-looking MyERAS page. It is a separate application, separate payment, separate document pipeline, and separate set of assignment rules. It also does not register the applicant for NRMP.

Build the application in ResidencyCAS, but manage ECFMG, FSMB, evaluators, specialty guidance, program requirements, and NRMP as parallel owners.

Who uses ResidencyCAS in 2027

ECFMG's current page names Emergency Medicine and Obstetrics and Gynecology. That is the specialty-level rule, not permission to skip program research.

Search the live ResidencyCAS program list, then open each program's own application page. Confirm the program name, track, accreditation status, visa policy, graduation-year screen, ECFMG Certification timing, document requirements, and deadline before payment.

A label of pending accreditation is not the same as ACGME accreditation. ResidencyCAS tells applicants to contact the program for current status.

Five systems, five different jobs

A green status in one system does not prove completion in another. The safest tracker has a separate column for each owner, a date requested, a date received, and evidence checked.

If applying to an ERAS specialty as well, add MyERAS as a sixth system. No application data should be assumed to transfer automatically between services.

Official 2027 timeline

The September 17 deadline is earlier than the September 23 program-view date. ResidencyCAS uses the intervening period for final readiness work, including verification of submitted materials and preparation of application data.

The platform may accept a submission after September 17, but that is not a promise of review. ResidencyCAS warns that many OB-GYN programs begin review immediately and may not routinely review late applications or materials. EM programs recognize that some SLOEs and scores may arrive later, but applicants are still encouraged to submit by the recommended date.

Treat September 17 as a finish line, not a starting point for proofreading.

IMG eligibility for access

ECFMG permits an IMG to register and apply before completing the examinations required for Certification. This is an access rule only.

It does not override a program's published screen, NRMP's deadline for ECFMG examination requirements, or state medical-board rules. An application can be technically deliverable and still be ineligible.

Exact ECFMG access workflow

The form says that the applicant's name, MyIntealth ID, and USMLE ID must match the Intealth record exactly; discrepancies stop processing.

Do not send page 1 alone. The form explicitly says it will not be accepted without page 2. Do not use an old form saved by a friend; use the live May 2026 version or whatever version ECFMG has replaced it with when you apply.

The official contact on the form is residencyapplication@ecfmg.org for questions. The signed form itself is directed to finance@ecfmg.org.

ECFMG support fee: $185 or $90

The discounted amount is not automatic merely because you intend to dual-apply. The support form ties the $90 rate to already having purchased the 2027 ERAS Token through MyIntealth.

If you pay $185 for ResidencyCAS support and later decide to apply through ERAS 2027, the form says you will pay the full ERAS Token fee and become eligible to request a $95 refund of the Residency Application Support fee. Contact ECFMG; do not assume it is automatic.

The form describes the support fee as nonrefundable even if the applicant does not apply, while also containing narrow reimbursement language if ECFMG's service fails to meet the stated standard. Read the controlling form rather than budgeting for a refund.

ResidencyCAS program fees

ResidencyCAS calculates the tiers separately for Emergency Medicine and OB-GYN. Applying to 20 in each specialty costs $135 plus $135, or $270, as the official example confirms.

The fee page states that special $10-per-program pricing applies to applicants submitting to nine or fewer programs overall, such as within a combined specialty.

Use My Programs → Calculate Fee before submission. No refunds are issued for missed deadlines, a program no longer accepting applicants, or a selection made in error. A submitted program cannot be swapped for another.

Budget examples

These examples exclude the separate FSMB USMLE transcript order, NRMP registration, ECFMG Certification and Pathway services, translations, specialty-specific expenses, and any MyERAS program fees.

A broad list is not automatically a strategic list. Pay only after confirming each program's IMG eligibility, visa policy, training-license implications, required evaluations, and current participation.

Build the application in four sections

ResidencyCAS is not a thin upload portal. Applicants must enter a full application across Personal Information, Academic History, Supporting Information, and Program Materials.

Use the official specialty worksheet before typing in the portal. Draft plain text, normalize dates and organization names, and compare every entry with the CV, MSPE, transcript, prior applications, and interview narrative.

Download the full application PDF before paying. Read it as a reviewer would, not only as a collection of green dashboard checks.

Dual-service applicants need two complete applications

Do not assume a certified MyERAS application, statement, experience, letter, or score becomes visible in ResidencyCAS. Reconcile both applications line by line.

ECFMG says its document instructions may vary when an applicant participates in multiple residency application services. Follow the individualized email instead of sending duplicate documents through an improvised route.

Use one source-of-truth CV and a cross-platform discrepancy checklist. Different field structures may require different wording, but dates, roles, degree facts, publications, and disciplinary disclosures should not conflict.

Document ownership map

ResidencyCAS automatically shares most required materials with selected programs, but evaluations are the critical exception: letters and SLOEs must be assigned manually.

ECFMG's transmission responsibility is limited. Its form states that ECFMG is not responsible for ensuring the application is complete or that it meets a particular program's requirements.

The applicant remains the final quality-control owner.

MSPE and medical school transcript

After ECFMG processes the support form, its residency application support team sends applicant-specific instructions for the MSPE and medical school transcript. The path may differ for an applicant using multiple application services.

An MSPE should evaluate academic performance relative to peers, appear on medical school letterhead with the school seal, be signed by the designated official, and include the applicant's full name.

A transcript should include the full name and clearly show subjects, duration, and performance. ECFMG warns against security paper or a busy background that makes a scanned image illegible; ask the school to copy it onto plain paper.

Transfer students who need more than one medical school transcript should tell the ECFMG support team when contacted.

Translation and placeholder rules

ECFMG accepts a certified English translation prepared by a medical school official, government official, or professional translation service. Its current guidance says to submit only the English translation.

If the school cannot provide an MSPE or transcript, ECFMG can provide a neutral placeholder that tells programs the document is supplied in lieu of the missing item and directs questions to the applicant.

A placeholder can make the file appear complete for a program that requires the document, but it cannot supply the comparative or academic evidence a real document would contain. Explain the institution's practice accurately if asked.

ECFMG Status Report

The ECFMG Status Report is not a score transcript. It includes identifiers, ECFMG Certification status, certificate issue date, exams passed for Certification, medical school and degree year, medical education credential status, and explanatory notes when applicable.

For Pathways applicants, the report can identify that clinical and communication skills requirements were met through a Pathway. A Pathway-based certificate's expiration date is listed.

ECFMG says the 2027 Status Report will be generated and transmitted to ResidencyCAS in early September 2026. If status changes afterward, an updated report is transmitted within one week.

A pending Status Report is not corrected by uploading a screenshot of MyIntealth. Verify the underlying Certification or credential record and allow the stated update window.

USMLE transcript workflow

Paper score reports are not accepted. Official USMLE scores come electronically from FSMB and are sent to every ResidencyCAS program to which the applicant applies.

Scores are transmitted in batches and may take up to 24 hours to post. Applicants cannot view the actual score in ResidencyCAS, but can confirm receipt.

Only requested scores post. A later result requires a new request from the USMLE and COMLEX Scores section. The official help center limits re-requests to once every 24 hours.

If scores remain missing, first confirm when FSMB sent them. Name or birth-date differences—including hyphens, apostrophes, and former names—can prevent automatic matching and may require ResidencyCAS customer service to connect the record manually.

Personal statement and headshot

ResidencyCAS asks why the applicant wants to be considered for the specialty and shares one statement with every program in that specialty. It does not support a different statement for each program.

The live field is the authority for the maximum length. Spaces, punctuation, and line returns count as characters, and the system will not save an over-limit response.

A headshot and personal statement must be fulfilled before submission. The document page currently provides an upload workflow but does not publish detailed pixel or file-size specifications in its public instructions; follow the live uploader instead of importing MyERAS photo rules.

Evaluations, letters, and SLOEs

Applicants may request multiple evaluations, but only four can be assigned and submitted to a program. The cap includes both SLOEs and narrative letters.

For EM, ResidencyCAS supports eSLOE, non-residency-based SLOE, subspecialty SLOE, off-service SLOE, and narrative letters. Most EM programs expect at least one SLOE, but the exact number and acceptable type are program decisions.

For OB-GYN, ResidencyCAS highly recommends a Standardized Letter of Evaluation. Its guidance says the writer should be the person or group who knows the applicant best—ideally an OB-GYN, preferably from a sub-internship—and that the same writer cannot also submit a separate narrative letter.

Evaluators receive the request electronically. Confirm the preferred email in advance and warn the writer to check spam for mail from applicantsupport@residencycas.com.

The manual assignment trap

A completed evaluation is not enough. ResidencyCAS's quick-start guide says letters and SLOEs are the application components that require manual assignment to selected programs.

In Program Materials, open Assign Evaluations, move through each evaluation, select the intended programs, and save. Repeat until the program-by-evaluation matrix matches the strategy.

Use a spreadsheet with programs as rows and evaluation names as columns. Mark requested, completed, assigned, and program status separately.

If the evaluator email is wrong, the help center instructs applicants to delete an incomplete request and add it again with the correct address. A completed evaluation generally cannot be removed or replaced casually.

Waiving access to evaluations

Before an evaluation request is sent, ResidencyCAS requires the applicant to choose whether to waive the right to inspect it. The decision is disclosed to the evaluator and programs and cannot later be changed.

Selecting Yes means the evaluator wrote with the understanding that the applicant could not view the content. Selecting No does not make the letter visible inside ResidencyCAS; it means the applicant may ask the evaluator for a copy.

Do not click quickly to clear a dashboard item. Decide once, apply the decision consistently, and understand what programs will see.

2027 ResidencyCAS signals

Signals are applied inside Program Materials. Choose the program or programs, apply the signal, and review the result before submission.

The EM instruction not to signal home or away rotation sites is a specialty-specific rule and differs from some MyERAS specialties. Do not recycle another specialty's strategy.

For OB-GYN, signal tier communicates relative interest. Build the list only after checking program eligibility and fit; a signal cannot rescue an application that fails a hard screen.

Because signal rules can change by cycle, treat the live ResidencyCAS Program Materials page and specialty organization guidance as controlling.

Emergency Medicine application notes

ResidencyCAS acknowledges that some EM SLOEs and exam scores may not be available by the recommended submission date. That is not a reason to leave applicant-controlled sections unfinished.

Submit a coherent application on time, monitor late-arriving materials, and follow each program's stated policy about later SLOEs or scores.

• Use the Emergency Medicine worksheet, not the OB-GYN version.
• Plan EM rotations and SLOE timing together; the application deadline cannot create a letter before the evaluator has observed you.
• Classify each requested evaluation correctly as a SLOE or narrative letter.
• Follow CORD's current definitions for eSLOE, non-residency, subspecialty, and off-service SLOE.
• Assign no more than four total evaluations to a program.
• Use five equal signals and do not signal home or away rotation sites.
• Submit by the recommended date even if an expected SLOE or score will follow.
• Check combined EM tracks individually; do not infer their requirements from the categorical program.

OB-GYN application notes

ResidencyCAS's OB-GYN deadline guidance is unusually direct: many programs begin review as soon as access opens and may not routinely return to late applications or newly received materials.

For an IMG, that makes school document coordination, ECFMG access, and translation work early-summer tasks—not September tasks.

• Use the current OB-GYN worksheet.
• Review APGO's Right Resident, Right Program, Ready Day One applicant resources.
• Plan for an OB-GYN SLOE from the person or group best positioned to evaluate you.
• Do not request both an SLOE and separate narrative letter from the same writer.
• Check whether each program requests a chair's letter.
• Use up to three gold and fifteen silver signals deliberately.
• Finish program materials and supporting documents before the September 17 deadline.
• Assume late material may not receive routine review unless the program says otherwise.

Submitted is not Complete

Submitting means completing sections within your control, clicking Submit, and paying. It does not mean every supporting item has arrived or that a program has begun review.

In general, Complete requires the official medical school transcript, MSPE, required evaluations, payment, successful submission, and a Complete program status. The quick-start checklist also includes official exam scores and the ECFMG Status Report for IMGs.

Check status program by program. A global confirmation email does not prove that every evaluation was assigned or every program-specific requirement was satisfied.

Final review before payment

• Download and read the full application PDF.
• Verify legal name, date of birth, MyIntealth ID, USMLE ID, and CAS ID.
• Reconcile every date and organization with the CV and other application systems.
• Open every program's Program Materials section.
• Confirm the correct track, deadline, and accreditation status.
• Confirm visa, graduation-year, ECFMG, and state licensure eligibility.
• Proofread the specialty-level personal statement in the generated PDF.
• Verify the headshot is uploaded.
• Review every disclosure and interruption response.
• Confirm each evaluator type and irrevocable waiver choice.
• Confirm no more than four evaluations and the correct assignment for each program.
• Confirm signal assignments and specialty rules.
• Confirm MSPE, transcript, Status Report, and USMLE transcript statuses.
• Run the fee calculator.
• Save the program list and a timestamped final PDF before paying.

What can change after submission

Most application sections lock at submission. The help center permits limited contact/profile edits, new programs, certain new entries, and some evaluation changes.

If a material correction cannot be made in the application, ResidencyCAS directs applicants to send the update directly to their programs. Use a concise factual correction and keep proof of delivery.

Do not create a duplicate ResidencyCAS account to correct a mistake. Duplicate accounts can cause applications to be placed on hold.

NRMP registration and ECFMG examination deadline

ResidencyCAS delivers an application; NRMP runs the matching algorithm. Completing one does not create registration in the other.

ECFMG states that an IMG must register with NRMP by the NRMP late-registration deadline for ECFMG to verify examination requirements. The passing results or satisfactory completion required for Certification must be available by the NRMP Rank Order List Certification deadline.

Certification itself, Pathway processing, credential verification, program eligibility, Match eligibility, and the ability to begin training are related but distinct gates. Build separate deadline rows for each.

Use the live NRMP calendar and ECFMG Pathways timeline before scheduling an exam or OET close to a deadline.

Troubleshooting

Common IMG mistakes

• Buying only an ERAS Token for an Emergency Medicine or OB-GYN application.
• Waiting for a medical school to send the IMG access link instead of using ECFMG.
• Submitting only page 1 of the ECFMG support form.
• Typing a name or identifier that does not exactly match MyIntealth.
• Paying $185 when already eligible for the $90 dual-service rate.
• Assuming the ECFMG support payment includes ResidencyCAS program fees.
• Assuming MyERAS data or letters transfer automatically.
• Uploading a self-made MSPE, transcript translation, or unofficial score report.
• Assuming ECFMG sends the USMLE transcript.
• Requesting scores in ResidencyCAS before completing the FSMB order.
• Failing to re-request a newly released score.
• Requesting the wrong SLOE or letter type.
• Assigning more than four evaluations or forgetting assignment entirely.
• Using the wrong specialty's signal strategy.
• Signaling an EM home or away rotation site.
• Trying to personalize the specialty-level personal statement by program.
• Treating Received as Complete.
• Submitting after September 17 because the portal technically permits it.
• Assuming ResidencyCAS registers NRMP.
• Creating a duplicate account to correct an application error.
• Paying for a program before verifying visa, ECFMG, graduation-year, and licensure eligibility.

Final 2027 checklist

• I verified that each intended program and track uses ResidencyCAS.
• I have the correct MyIntealth and USMLE Identification Numbers.
• I downloaded the current two-page ECFMG support form.
• My name and IDs match MyIntealth exactly.
• I selected the correct $185 or $90 support option.
• I saved the payment receipt and sent both signed pages.
• I registered only through ECFMG's individual access link.
• I saved my CAS ID and opened the correct 2026–2027 cycle.
• I completed all four application sections.
• I reconciled the application with my CV and any MyERAS application.
• I followed ECFMG's specific MSPE and transcript instructions.
• Any translation meets ECFMG's certification rule.
• I confirmed the ECFMG Status Report.
• I completed the FSMB USMLE transcript order.
• I requested scores in ResidencyCAS on or after August 24.
• I uploaded the required headshot.
• I finalized the correct specialty-level personal statement.
• Every evaluator received the request and completed the right letter type.
• No program has more than four evaluations.
• Every intended letter or SLOE is manually assigned.
• My EM or OB-GYN signals follow the current rule.
• Every program-specific question is complete.
• I downloaded and read the final application PDF.
• I used the fee calculator and verified the program list.
• I submitted and paid by September 17 at 11:59 p.m. Eastern.
• Every program status is Complete or has a documented expected item.
• I registered separately with NRMP and tracked ECFMG examination deadlines.

Bottom line

For an IMG applying to Emergency Medicine or Obstetrics and Gynecology in the 2027 season, ResidencyCAS is a separate application ecosystem. Start with ECFMG authorization, not an ERAS Token or a school invitation.

Pay the correct ECFMG support fee, complete both pages of the form, and build the application early enough to coordinate school documents, FSMB scores, specialty evaluations, and signals before the September 17 deadline.

The high-risk details are small but consequential: a $90 dual-service rate, exact ID matching, manual evaluation assignment, specialty-specific signals, and the difference between Submitted, Received, and Complete.

This guide reflects official information available July 19, 2026. The live ECFMG form, ResidencyCAS Help Center, specialty organizations, individual program pages, FSMB, and NRMP control if any rule changes.