Medicine is a calling, many people feel. You don’t choose it. It chooses you. As far as which programs physicians train in, that comes down to a rank-order list.

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What factors do medical students consider most—and least—when choosing residency programs? Recent data released by the National Resident Matching Program (NRMP) shed some light on that question.

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Every other year, the NRMP conducts a survey that aims to weigh the factors to which applicants give strongest consideration when applying to and ranking programs. Of those applicants who completed a rank-order list, more than 8,800 responded to the 2021 version of the survey.

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Survey respondents were asked to list the factors that influenced both application and ranking choices and the relative importance of each of those factors on a scale of one to five. These factors may be worth keeping on a medical student’s radar in advance of the March 2 deadline for fourth-year medical students to submit their Match rank-order list.

Learn the do’s and don’ts of creating a rank-order list from one intern.



Among active U.S. allopathic senior medical students ranking to residency programs across all specialties, these were the top five considerations.

  • Desired geographic location—cited by 90.2%. 
  • Perceived goodness of fit—88.7%. 
  • Reputation of program—84.6%. 
  • Quality of residents in the program—76.1%.
  • Work-life balance—75.2%.

The top five factors listed by applicants who were active U.S. osteopathic senior medical students ranking programs—on their final Match rank-order list—were as follows: 

  • Perceived goodness of fit—86.5%.
  • Desired geographic location—86%. 
  • Work-life balance—77.5%.
  • Quality of residents in program—75.7%. 
  • Quality of program director—70.9%.

For both groups of applicants, work-life balance was a new entrant into the top five from the last time the survey was conducted in 2019. For MD applicants, that the program they applied to was in an academic medical center dropped out of the five most important criteria. For DO applicants, the quality of program director criteria was a new addition to the top five. Interview-day experience—likely due to programs moving interviews online—and the reputation of the program dropped out.

Feeling uncertain about your rank-order list? Here’s what you should know.

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DO vs. MD: How much does the medical school degree type matter?

Here are some other interesting nuggets from the survey.

U.S. MD seniors most commonly ranked the programs in order of their preference, with 95% citing that as a strategy for ranking programs, compared with 93% for U.S. DO seniors. Nearly 80% ranked all the programs they were willing to attend (75% for DOs), and 74% ranked all programs with which they interviewed, regardless of preference. A smaller share of DO applicants, 68%, ranked all the programs with which they interviewed.   

The median number of applications submitted by U.S. seniors who matched was 33. The median number of interviews offered to matched U.S. seniors was 16, with those applicants attending a median of 14 interviews. Matched U.S. seniors ranked an average of 14 programs.

Matched DO applicants applied to more programs, with a median of 49. But their median number of interview invitations was 16, with those applicants attending 14 interviews and ranking 13 programs.

The median number of applications submitted by U.S. MD seniors who did not match was 45. The median number of interviews offered to applicants who did not match was 15, with those applicants typically attending 14 interviews and ranking a median of 13 programs. 

The median number of applications submitted by unmatched DO applicants was 61 programs. Those applicants received a median of 12 interview invitations and typically attended 12 interviews and ranked a median number of 12 programs.

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