Prepping for residency

How to prepare your best possible Match rank order list

Three physician experts offer their advice for a highly unusual Match cycle. Get their opinions on fellowships, backup plans, doing things virtually and more.

Editor’s note: This story was updated on Nov. 18, 2021.

It’s almost time for this year’s residency applicants to start thinking about preparing their rank order lists, which will determine where everyone ends up on NRMP Match Day 2022. List entry will be open from Feb. 1 to March 2.

With in-person interviews largely removed from the process this year due to COVID-19, many students may be feeling pressure to hedge their bets by ranking programs outside of their interests to ensure they match, rather than submitting a list that fully reflects their career goals. James Small, MD, PhD, a clinical career advisor at Rocky Vista University College of Osteopathic Medicine, says he is urging students to stay the course.

“Your rank order list is still your rank order list,” Dr. Small said. “Start with your favorite program and go on down, and don’t rank any programs where you didn’t interview. Don’t try to outsmart the program directors or the Match algorithm or overthink it. Just rank your preferences.”

To help students make sense of a stressful process, The DO spoke to Dr. Small and two other physician experts, who shared their best advice for putting together a rank order list that works for you.

What are some important things for students to keep in mind when putting their lists together?

“Your number one program really ought to be the place you want to go the most. It’s that simple. But you also need to be able to seriously consider that you may end up in any program that you rank. Make sure you are very comfortable ending up at any place that you rank, and that you really would be OK going there.” — Jason Miller, DO, psychiatry program director at the Texas Institute of Graduate Medical Education and Research, associated with the University of Incarnate Word School of Osteopathic Medicine

“If you’re not determined to match into a specific specialty, you should look into doing a traditional intern year to expose yourself to different specialties and lifestyles. If you want to do a competitive specialty, evaluate your scores and where you’re likely to end up, and tailor your list to match the programs you think you have the best shot of matching in.

“If you’re applying to a primary care specialty and having trouble ranking programs, I’d recommend organizing them by your preferred geographic areas, or identifying anything particularly unique or special about each one.” — Taisei Suzuki, DO, core faculty member for The Wright Center for Graduate Medical Education National Family Medicine Residency Program in Washington, D.C.

Should students rank programs in their preferred specialty as well as similar specialties to have a backup plan?

Dr. Small: “It has to do with how competitive you perceive your application to be. If you already have a strong application with good board scores, that’s one thing, but if not, you’re going to have to analyze that and bounce ideas off a mentor or advisor. I’d just advise any student going after competitive specialties this year to consider an alternative track of some kind, but make sure that it aligns with what you really want to do.

“For example, if you want to do orthopedics, and it’s because you like sports medicine, family medicine has a lot of sports medicine opportunities. But if you love orthopedics because you love the operating room, then maybe you want to look at a surgical specialty as a backup.”

Is a program’s perceived prestige or “name brand” important?

Dr. Suzuki: “My mentor told me: ‘once you’re a doctor, you’re a doctor.’ No matter where you go, you’ll learn what you have to learn. Unless you’re getting into a hyperspecialized field, prestige is not that important. Focus on your impressions of the attending physicians and residents you’ve met from these programs, and if you can see yourself at these programs.”

What advice would you give to students who plan to pursue a fellowship after residency?

Dr. Miller: “If you know that you want to do a fellowship after residency, you’d like to know that a program you’re looking at has a track record of getting people into that fellowship.

“And if you’re looking at an extremely competitive fellowship, ranking a program at an institution that has one of them makes a lot of sense. Keep in mind that some fellowships aren’t terribly competitive, so in that case, it probably doesn’t matter if your program has it or not.”

How much should a program’s geographic location factor into where it goes on a rank order list?

Dr. Miller: “You really should factor in what city or town a program is in, and does it allow for you to live your life in a way you find comfortable? Think about what you’re interested in outside of medicine, too. There’s more to picking a program than just a program itself. People choose programs for different reasons. Sometimes it’s a gut intuition about the place, and that’s OK.

“Get as much information as you can to make your decisions, especially in places where you can’t go visit right now. This is a great year to reach out and ask those detailed, practical questions (i.e. commute time, what residents do outside of work), which is also a great way to demonstrate that you’re genuinely interested. It comes off really sincere.”

What resources can students use to get a feel for programs without being able to see them in person?

Dr. Small: “We’ve advised students to seek out virtual meetings like grand rounds or social get-togethers on Zoom. Spend as much time as you can looking into the parts of the program that may matter to you and try to get to know as many people as you can. COVID or not, we encourage students to look for alumni from our medical school at those programs to converse with to get their unique frame of reference.”

Dr. Suzuki: “We’ve been updating our website, which has an immersive video to show people our clinic’s atmosphere, and an informational video sharing the strengths of our program and what makes it unique. Some programs are sending applicants these materials, but if not, applicants should do their homework and make sure their interests match with those of the program, and that they’re a good potential fit.”

Related reading:

What can you do if you don’t match?

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