Preparing for Residency

Creating a Match rank-order list? Avoid these 4 common missteps

Brendan Murphy , Senior News Writer

AMA News Wire

Creating a Match rank-order list? Avoid these 4 common missteps

Jan 23, 2024

The methods to making a Match rank-order list are highly individualized. The factors an applicant values in a residency program will vary widely. Still, there are common themes and a few familiar mistakes that  residency applicants should look to avoid.

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Formerly the director of the ob-gyn residency program at Washington University in St. Louis (Wash U.), Eric Strand, MD, now works in the ob-gyn department at the University Hospitals Cleveland Medical Center and is a faculty member at the Case Western Reserve University School of Medicine.

As both a faculty member and former residency program director, he has worked with medical students and residents and been on both sides of the Match process. With the Feb. 28 rank-order list deadline looming for the 2024 Match, Dr. Strand cautioned about a few common missteps to avoid in ranking programs.

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As has been the case for the last several, largely virtual, Match cycles, getting all the details you need on a program may be more difficult. The goal of interview days, even in a virtual setting, is to get all the necessary information. If you have questions after your interview days, there is no harm in asking program directors, other faculty, or residents for direction.

Dr. Strand said that while he was at Wash U., he and his colleagues actively worked to respond to requests for additional information, working to get “students connected via email or Zoom with whomever they would want to talk to,” he said. That could be “a faculty in a particular division who can explain a little bit more about what that division has to offer,” for example, and Dr. Strand and his residency program colleagues were happy to accommodate such requests.

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The math is pretty basic: ranking more programs gives you more options. If you applied to a program, you obviously saw some merit to considering it. If a program invited you for an interview, the selection committee also saw some merit in your qualifications.

Considering all that—and the potential burdensome consequences of not matching—Dr. Strand said students need to give serious consideration to each program with which they interviewed.

“If you are leaving a program off your rank list, you are essentially saying that I would rather scramble during Match Week than end up at that program,” he said. “There must be major red flags. If you were so unhappy with the interview experience and the people you met, then trust your impressions. Just understand the consequences. Most applicants rank all the programs with which they interviewed.”

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Programs may reach out to you after an interview with what sounds like positive messaging, and the National Resident Matching Program allows for interviewers to “freely express their interest in a candidate.” Still, any sort of post-interview correspondence should be taken with a grain of salt, Dr. Strand said. Reading into that type of correspondence—ranking a program higher or leaving other programs off your rank list because of it—can be a misstep.

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Dr. Strand gave the hypothetical of a program reaching out and saying, “We’d love to see your name on Match Day.” That comment, he said, could be read in a number of ways.

“Those sorts of vague comments are very open to interpretation,” he said.

Dr. Strand added that the residency programs he worked with didn’t send “any communication like that. It’s too fraught with trouble for a potential misunderstanding. I don’t want to take a chance of misleading a student.”

Such a comment from a residency program could mean an applicant is in the top third, top half or even something less.

“Maybe they send it to every one of their applicants,” Dr. Strand said.

If you feel as though your dream program is a reach, but you got an interview, rank it first. In the end, the Match tends to work out, with roughly 80% of applicants landing at one of their top four choices. “The Match algorithm works to benefit students,” Dr. Strand said. “Rank the programs in the order you prefer them. Not in the order in which you think you are competitive.”

“If you think you have a better chance of matching at program A, but program B is your dream program, you should rank program B first. Sometimes students get a little too caught up in thinking, ‘I’m a better candidate at this program so I might as well rank them first or second,’ instead of really going with their gut and ranking the programs you loved the best first, second and third.”