A match made in heaven? How to create your rank order list


Posted on September 9, 2020 by Carol McPhail
Carol McPhail


Medical students at the USA College of Medicine display their match letters at 2019's Match Day Ceremony. data-lightbox='featured'
Medical students at the USA College of Medicine display their match letters at 2019's Match Day Ceremony.

Like her classmates, fourth-year medical student Ashley Cainion has been looking forward to Match Day since she started medical school at the University of South Alabama College of Medicine. With the date about six months away, Cainion is using a spreadsheet to guide her in ranking family medicine residency programs.

“I’m learning about what makes programs different and what I need in a program,” said Cainion, who will begin interviews in late 2020 to early 2021. “I want to be able to have everything in one place so that I am able to compare them.”

Applying, interviewing and ultimately matching in a residency program is a daunting process for medical students. They are tasked with weighing a variety of factors, from a program’s competitiveness to its location and “feel,” and creating a rank order list (ROL) of where they prefer to train for the next three to seven years.

Students submit the list to the National Resident Matching Program at the same time that residency program directors submit their own list of applicants ranked in order of preference. The NRMP’s matching algorithm processes the final preferences of applicants and program directors to produce a match outcome.

“We encourage our students to rank the programs not only based upon the quality of the healthcare system but also the attributes of the community in which they will immerse themselves,” said Kelly Roveda, associate dean for student affairs at the USA College of Medicine.

For Patrick Young, who graduated from the USA College of Medicine in 2020, interacting with USA’s orthopaedic surgery residents as a med student informed his decision to rank USA at the top of his list. So did a desire by Young and his wife, Lucy, to stay in Alabama, where they are close to family.

“There are plenty of great orthopedic surgery programs that offer excellent training,” he said. “Everyone has different things they look for in a program. I wanted a program that provided an early operative experience, hands-on training and a close-knit group of residents. USA orthopedic surgery fit all of those criteria and is widely known to produce confident and competent orthopedic surgeons.”

In March, Young opened an email at a virtual Match Day and got the news he was hoping for.

“I was very happy to get my No. 1 spot,” he said. “It was where we wanted to be for the next five years. I’m excited to join the program and get to work alongside the residents and faculty I’ve grown to know throughout medical school.”

Young acknowledged that finding the right program means different things to different people. “I would say take all the advice you can get,” he said. “My best advice is to find a program that fits your specific needs and provides you the best opportunity to be successful in your career as a physician.” 

Fourth-year medical student David Marks plans to specialize in the combined fields of internal medicine and psychiatry.  He said a smaller, combined specialty means fewer spots for applicants.

“As there are few med/psych residency programs, I’m also applying to psychiatry programs to increase the chances of receiving more interviews,” he said. “The more interviews, the higher the likelihood of matching.”

Marks is factoring in a number of pros and cons for his list, including geography, education, patient population, resident outcomes, schedule, cost of living and more. Also on his mind is the setting, culture and leadership of a program. “This is hard to assess, especially when interviews are conducted online,” he said.

To gain more insight, Marks is reaching out to residents in the combined programs to ask about their experiences. “I sent emails to program coordinators and asked to talk to a current resident,” he said. “I also spent extensive time networking on Twitter, which has been a great tool given the limitations during COVID-19.”

The NRMP offers these additional tips on its website:

·         Be sure to rank programs in order of your true preference and not where you think you will match.

·         Rank only those programs where you are able and would be happy to train.

·         Do not rank programs where you did not interview.

·         Be realistic about your competitiveness and the competitiveness of your preferred specialty.

·         Do not wait until the last minute to enter your ROL in the system.

·         Do not make last-minute changes to your ROL.


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