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

Brendan Murphy , Senior News Writer

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 medical students and other residency applicants should look to avoid. 

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Eric Strand, MD, is a professor of obstetrics and gynecology and directs the ob-gyn residency program at Washington University in St. Louis (Wash U.). Working with medical students and running a residency program, he has been on both sides of the Match process. With the March 1 rank-order list deadline looming for the 2023 Match, Dr. Strand cautioned about a few common missteps to avoid in ranking programs.

As has been the case for the last three, 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 Wash U. has actively worked to respond to requests for additional information.

“We have relied much more upon getting students connected via email or Zoom with whomever they would want to talk to,” he said. “If that’s a faculty in a particular division who can explain a little bit more about what that division has to offer, we’re happy to set that up for them. If it’s connecting with a resident to learn about resident life or what it’s like in St. Louis, we will make sure to accommodate that for them.”

The AMA Road to Residency series provides medical students, international medical graduates and others with guidance on preparing for residency application, acing your residency interview, putting together your rank-order list and more.

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Match ranking advice: Trust your gut

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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Figure looking at a winding road

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. “We don’t, as a program, 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,” Dr. Strand said, “they send it to every one of their applicants.”

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 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.”