The only thing certain about submitting a rank-order list as part of the Match process is that each prospective resident is going to feel at least some level of uncertainty—and that’s true even during a normal cycle.

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With the COVID-19 pandemic preventing residency applicants from traveling to programs for in-person interviews, that uncertainty is perhaps more abundant in the 2021 residency application cycle than any prior year.

Chantal Young, PhD, director of medical student wellness at the Keck School of Medicine of the University of Southern California (USC), has counseled students going through an unprecedented Match. She shared with readers the advice she’s been offering directly to residency applicants.

Programs have worked to create a virtual interview day experience that rivals the in-person one. But video tours aren’t the same as physically walking the wards. The information at your disposal is less than it would be in typical times, but that’s the case for every participant in this year’s Match.

“Self-doubt about rank lists isn’t new, but now the increased uncertainty because of COVID is new,” Young said. “But that’s the case for each student. No student is at a disadvantage comparatively to others.”

Submitting a rank-order list, as a medical student, is likely the biggest career decision you have made to date. But other, more significant decisions are going to follow it. And no decision can’t be undone.

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“The perspective should be that no choice is final and you are doing the best you can with the information you have today to make an educated guess about what is going to bring you the most fulfillment,” Young said.

How a program aligns with your life goals, not just your career goals, is an important part of finding the right fit in a residency program. For some students, Young is finding, the pandemic has changed those values.

“It used to be maybe you would hop off to the most competitive residency or the coolest city,” Young said. “For all of us, COVID has readjusted how we are thinking about things. So, if it turns out staying close to family is more important, and you might not have reflected on that otherwise, or you know you want to put roots down near family.

“Some of our students feel less willing to forgo their normal self-care,” Young added. “That could mean choosing less competitive residencies than they may have otherwise.”

Residency applicants are less able to get information about each program because they are doing the entire application process remotely. Residency program webpages and social media accounts are good resources. But nothing is better than hearing it from the source. “We are encouraging more communication with our alums at various sites,” Young said. “Getting them to get over that hump and reach out for guidance. Ask those questions they don’t feel like they are getting the chance to ask during interviews: What’s this specialty like? What’s this site really like?”

You’ll never feel completely satisfied with your rank-order list. Knowing that going in can make things easier.

“The truth about rank lists is there is no perfect rank,” Young said. “There are just different ways to prioritize competing pros and cons. So students shouldn’t feel like they are trying to find the perfect list. Rather, they are making a list for what their best guess is about what will make them happiest at the time they make the list.

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“If you have their goals and priorities and values straight and try to choose a site based on those, not what somebody else wants for you or what you think you should want, but what you actually deeply value, that’s the best any of us can do.” The AMA has curated a selection of resources to assist residents, medical students and faculty during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing

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