Rank Order List: Hints and Tips

Creating a Rank Order List on NRMP can be difficult for residency candidates to face alone.

There are many questions you may have about the process, and your own personal considerations to take into account as you try to build a Rank Order List that will not only make you happy but also increase your chances to Match.

First, we recommend watching this overview of Match A Resident’s Rank Assist Feature:

To help you make your decisions, below are some tips to keep in mind as you create, change and certify Rank Order Lists.

  • Rank all of the programs you interviewed with, but only the programs you interviewed with
    • You can technically rank programs you did not interview with, but there is virtually no chance these programs will rank you back without an interview
    • This does not apply to residency programs you truly did not like or absolutely cannot imagine training in
  • According to NRMP®, the most successful candidates rank an average of 10 programs (some sources say 7 programs for International Medical Graduates)– but remember you can rank up to 20 unique programs before you are charged any extra fees
  • All sources and official services agree, rank according to preference, not where you think you have the best chance
    • You lose nothing for ranking according to preference, but you may lose if you only rank “safe” programs
    • For example, if you rank a “safe” program higher than a program you really wanted and you Match to both– you will lose your chance to be in the program you preferred
  • Do not assume a program is guaranteed to rank you based on a promise from any of the faculty  
    • They may have liked you, but you must remember programs interview far more applicants than they rank. You don’t know who they interviewed after you
    • You can include a program’s perceived impression of you in your considerations, but it should not be your only reason to rank a program higher than others
  • If possible, get someone qualified to look over your list (mentor, current physician, etc.)
  • Approach Letters of Intent with caution:
    • According to NRMP, programs cannot ask information about how or who you are ranking
    • You are allowed to express your genuine interest, but do not create any pressure for them to respond
    • You also do not want to make the program uncomfortable or put them in a position where they may violate NRMP’s policies with regards to confidentiality
    • Avoid the terms “first” or “#1.” Instead, consider saying something such as “I will be ranking you highly.”

When you have all of the programs you want and like added to your Rank Order List, the decision is down to the program order. To help you think objectively about how to rank programs you are listing, below is a list of things to think about with each program.

Ranking Considerations:

  • How much you liked the program
  • How well you did in the interview
  • Your competitiveness as a residency candidate such as:
    • USMLE Scores
    • Gap in medical education
    • Visa status
  • Competitiveness of the specialty and/or program
  • Happiness of the current residents/faculty
  • Your Personal Preferences
    • Geographic location
    • Benefits (salary, hours, vacation/sick time, daycare, etc.)
    • Further career opportunities (Fellowships, research, etc.)
    • Prestige of the program (if this matters to you)
    • Community vs. University-based programs
    • Opposed vs. Unopposed Programs (if the hospital has programs for multiple specialties or not)

If you were not able to secure any interviews and cannot make a Rank Order List, do not panic. Your residency season is not over yet.

Read Match A Resident’s full Rank Assist Tutorial here!

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