After submitting applications, residency applicants are often left to wait. First, they must wait for residency interview invitations, then they wait on a rank-order deadline, and finally on their Match result.
Amid all that waiting, medical students eager for news on the next chapter of their career may want to reach out to residency-program contacts. That raises some key questions. Which types of messages are permitted and prohibited? How might communication norms differ by specialty? The AMA is here with the answers.
Pre-interview communication
Policies put in place and enforced by the National Resident Matching Program (NRMP), the organization that oversees the Match process, allow for communication between applicants and programs during the entirety of the residency-selection process.
NRMP rules don't bar applicants and programs from communicating during recruitment. They do establish important boundaries, however, for both residency applicants and programs. Residency programs, for example, cannot ask applicants to disclose where else they applied or interviewed or where they sent preference signals.
The AMA has joined with the Organization of Program Directors Association and the Association of American Medical Colleges (AAMC) in launching the “Program Directors Association Guide for Residency Applicants.”
The resource—launched in 2025 and updated for the 2026–2027 cycle—is a series of documents that include specialty-specific guidance to boost transparency and help program directors and medical students navigate the process.
Generally, the guidance advises against any outreach in which applicants are communicating interest. With program signaling now a formal part of the application process in many specialties, applicants often already have a mechanism for conveying that message.
There are, of course, plenty of legitimate reasons to contact a program. Questions about interview scheduling and logistics are appropriate to direct to program coordinators. Applicants may also need information that is not available through a program's website or other recruitment materials.
Learn more with the AMA about how these specialty guides demystify the residency-application process.
Post-interview communication
The NRMP's Match Code of Conduct advises applicants to limit post-interview communication. Applicants can contact programs to ask questions or clarify information they need to make an informed decision. What they shouldn't do is use those conversations to try to determine or influence how a program intends to rank them.
Programs cannot ask applicants to reveal their ranking preferences or make placement on a Match rank-order list contingent on an applicant’s providing a verbal statement of preference. That doesn't mean applicants have to keep their own preferences secret. NRMP policy allows applicants to voluntarily communicate their interest in a program. Programs likewise can voluntarily tell an applicant that they are viewed favorably. The line is crossed when either side seeks a reciprocal commitment.
The specialty-specific post-interview guidance generally moves away from thank-you notes and letters of intent. Instead, the guidance advises either no communication; limited, necessary communication; or clear, program-specific expectations. Specialties that strongly discourage post-interview communication include dermatology, emergency medicine, internal medicine and orthopaedic surgery.
Other fields, including diagnostic radiology, shift toward recommending that residency applicants follow the program’s lead.
Expressing explicit interest
For a 2024 study published in the Journal of the American College of Radiology, researchers examined how post-interview communication was used in the residency Match. A survey of 69 residency program directors (PDs) participating in the 2021 Match found that advice to students about applicant-initiated post-interview communication varied. About one-quarter of responding PDs advised students to send a thank-you note or email, but not engage in any other post-interview outreach. By contrast, 33.8% of the PDs surveyed said they advised students both to send thank-you notes and to tell their top-choice program that it would be ranked first.
Communicating that top preference can often be done through a letter of intent, which generally communicates particularly strong interest in a residency and may explicitly tell a program that an applicant intends to rank it first. NRMP rules don't expressly prohibit applicants from sending such a message.
Some specialties have said applicants should not send letters of intent, so applicants should follow those recommendations unless they have a compelling reason to contact a program, such as sharing an important update not in the application.
A former medical school dean for student affairs and professor of family medicine, David Henderson, MD, is the AMA’s vice president of medical education and workforce development.
“From a student perspective, the major goal of the residency application process is to meet the expectations of the programs to which one is applying,” Dr. Henderson said. “It is particularly important to be familiar with the expectations of programs regarding communication and follow them. The system works best when everyone follows the rules of the road."
In addition to specialty guidance, applicants would be wise to lean on mentors in their preferred field to inform any communication strategies.
