5 Things You Need to Know About Ranking Residencies for the Match

Last Updated on June 26, 2022 by Laura Turner

As you continue researching residency programs, applying, and interviewing with these programs, you’ll begin to learn more about what you’re looking for and which options exist. Pretty soon, you’ll need to turn your attention towards creating a rank order list (ROL) in order to eventually be matched with a program that you’ve interviewed with.
While this can be a daunting proposition, it’s imperative that you take it seriously and meticulously review every last detail.
Understanding the Match Process
Because residency programs are so competitive and thousands of students apply to various programs each year, the National Resident Match Program (NRMP) uses an algorithm-based matching system that they believe is as fair, secure, and confidential as possible.
“The algorithm is ‘applicant-proposing,’ meaning the preferences expressed on the rank order lists submitted by applicants, not programs, initiate placement into residency training,” The NRMP explains. “As a result, no applicant could obtain a better outcome than the one produced by the algorithm.”
The process unofficially begins with applicants interviewing and researching various programs. Once the student has developed a list of possible programs, they create their ROL. The matching algorithm then attempts to match each application to the program that’s most preferred on their list. If the applicant cannot be matched with that first program, an attempt is made to match them to the second choice, and so on. This process goes on until each student has a “tentative” match, or all of the ROL options have been negated.
The beauty of the match process is that students have some control over where they go. They won’t be accepted to a program they don’t include on their ROL – and have a chance to be matched with their first preference before moving onto another program.
From a program perspective, there are similar benefits. They won’t be matched with students they don’t want – and have a chance to be matched with their most desired applicants.
Tips for Ranking Residency Programs
With so much riding on the match process – and specifically your ROL – it’s totally natural to feel some pressure. You can take a deep breath, though. The match system has a strong track record for placing applicants in the right programs. You won’t always get your first or second choice, but if you’re honest with your rankings, you should end up in a program that’s right for you.
Since you likely have a bunch of questions and concerns about ranking residency programs, we’ve decided to provide you with a few key tips and pointers to make the process go smoothly.
1. Assess a Program on the Right Metrics
When assessing programs, it’s important that you look at the right metrics. While you’ll have a lot of information in front of you to help you determine which programs should be higher on your list than others, a lot of it is superfluous. Make sure you focus on what really matters.
Some of the top things to consider are quality and reputation of the program, research opportunities, location of the program, and the importance of teaching. You also want to consider whether you felt comfortable with the program when you toured and interviewed.
2. Don’t Try to Outsmart the System
There’s no way to outsmart the system. The match program is a complex combination of variables and it’s impossible for you to identify loopholes or methods for increasing your chances of getting accepted into a particular program.
Here’s the one truth you must always remember: No student ranked lower on a program’s rank list can take your spot, unless you’ve already been matched to a program that’s higher on your list. The system is as close to perfect as they come.
3. Be Careful With Letters of Intent
When writing letters of intent to various programs, proceed with caution. Programs are not allowed to ask you for information about your ROL – and you shouldn’t give it to them. You’re allowed to tell them that you’re interested in the program and plan on ranking them highly, but it’s in your best interest to avoid further details.
4. Speak With Current Residents
It’s very important that you think about the details of the process. It’s not just about getting matched with a highly ranked residency program. Remember that you’re going to spend three to five years of your life in the program. With that in mind, it’s smart to speak with current and past residents to get a better idea of what it’s like.
Are residents happy? Is there a healthy teaching environment, or does the program not seem to care about the smaller details of helping residents grow? Program directors will always “talk up” their programs, but residents won’t be afraid to tell you the truth.
5. Have Safety Options
It’s natural to have tiers of programs. For example, there may be two programs you really want to get into and another four programs that you’d be satisfied with – don’t limit your choices. Always provide as many options as possible – including safety options. It’s much better to get into one of your last choices than to be denied altogether and scramble into an undesired program.
Don’t Lose Focus of Graduation
While you certainly need to pay careful attention to ranking residency programs, remember that you’re still a student. You can’t afford to let your mind wander too far.
Meet with your academic advisor to ensure you’ll have all required paperwork, clerkships, and letters completed. Never assume anything at this point. You’re too close to the finish line to have a minor error or oversight jeopardize your future.
If you’re not quite ready to graduate and are simply looking ahead so you know what to expect, this is a good thing. However, don’t spend too much time worrying about residency programs. Right now, you need to focus your time and energy on passing classes and exams.