Preparing, and submitting, your Match rank order list to the AOA and/or the NRMP is a critical step in the residency application process. As the profession transitions to a single GME accreditation system, this will be the final year of the AOA match. Next year, most DO and MD students will participate in the NRMP Match. Because of the rank order list’s importance in helping determine where people land, it’s also a considerable source of confusion and stress for many would-be Matchers. Below, three experts on the matching process share their words of wisdom.
Understanding how programs rank you
When considering programs, students will want to weigh how their test scores and grades align with what each program typically looks for, along with how their audition rotations and interviews went.
The interview is key. Programs typically only rank students who they’ve interviewed, says Bill King, vice president for student services at Edward Via College of Osteopathic Medicine (VCOM).
The interview and audition rotation are probably the most important elements to consider, notes Thomas J Mohr, MS, DO, trustee for the Association of Osteopathic Directors and Medical Educators (AODME).
“The interview or audition rotation can go a long way in demonstrating your professionalism, communication skills, leadership potential, and your ability to get along with others,” Dr. Mohr says. “I would rather accept a student with lower scores who I know will work hard and be a positive force within the residency.”
When putting your rank list together, King recommends thinking outside the box to consider specialties that are similar to your first-choice specialty.
“If your preference is pediatrics, and you rank those programs as your top priority on your list, you might also list family medicine programs at the bottom of your list,” he says. “That way, if you don’t match into peds, you could match into family medicine, where you would still get exposure to children.”
Following this advice will mean students are ranking more programs, adding to their options, which is a good thing, King says.
“Having too few programs listed is a concern,” he says. “Speaking to a chairperson, administrator or faculty in graduate medical education will help students understand the profile and practices of candidates who’ve successfully ranked and matched, including how many programs they listed, and in which particular specialties.”
Ranking AOA or NRMP
In 2020, under a single GME accreditation system, most DO and MD students will submit their lists to the NRMP Match. This year, DO students have the option of participating in the AOA Match, the NRMP Match, or both matches. Because the AOA Match takes place earlier than the NRMP Match, if students submit rank order lists to both matches, those who go on to match in the AOA Match will then be removed from the NRMP Match.
As an example, Dr. Mohr says, “If your top choice is in the NRMP Match and your next three choices are in the AOA Match, you have a bit of a dilemma. If you match with an AOA program, you will be removed from the NRMP and have no shot at your top choice. But, if you don’t enter the AOA Match and don’t get your top choice in the NRMP, you have lost the opportunity for your back-up selection. This will no longer be an issue once all programs have transitioned to the ACGME.”
At VCOM, King encourages students to cast their nets wide and look at all options. “Most times, students apply to both matches,” he says.
Ranking with the big picture in mind
When putting your rank list together, you’ll want to consider not only your competitiveness with each program, but also things like location, program reputation and your future goals, says Harald Lausen, DO, chair of the AOA’s Bureau of Education.
“Look at geographical location. You get trained differently in a rural area versus in a big city. You’ll want to evaluate the reputation of the program and its offerings in light of your goals,” he notes. “Money, or a signing bonus, should not be the reason you choose a program. This is about training for the rest of your career.”
Dr. Mohr notes that location is just one element of a residency program.
“Location may be important due to family issues, but I would caution students to be willing to go anywhere to find the best education and the best fit, even if it is not in a tropical paradise,” he says. “Students should discuss their plans with a trusted mentor or advisor to help guide them on this path.”
Students planning to pursue a competitive fellowship may want to consider larger and more prestigious institutions for their residency, as long as they are competitive applicants, notes Dr. Mohr.
“Cutting specialities like surgery and orthopedics need to provide adequate numbers of required procedures to meet the graduate goals of the program,” he says. “However, it is still better to rank a smaller or less prestigious program where you will be happy and can thrive versus the well-known ‘Ivory Tower’ where you will be miserable.”
Important on the list of considerations is whether the program has, or is applying for, osteopathic recognition. “A program that has decided to pursue osteopathic recognition has demonstrated a commitment to continuing osteopathic training and advancing the philosophy and values that drew you to osteopathic medicine in the first place,” says Dr. Mohr. “It is important to keep up the skills and attitudes that make you unique as a physician.”
The process of putting your rank list together can be challenging, but understanding how the system works and the important factors to consider are critical first steps.
“The match process is complex, even for these very smart students, and navigating it can be difficult,” King says.
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