When it comes to Match, there are a number of factors that play into finding the right program from an applicant’s perspective. Some of the obvious ones include a program’s reputation, interactions with residents and faculty during the interview process and the likelihood of acceptance.

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There are also many below-surface-level considerations. In advance of the Feb. 26 deadline for fourth-year medical students to submit their Match rank-order list, physicians offered insight about the factors medical students may overlook in their match rankings.

“The biggest bit of advice I’d offer is to not think that residency has to crush your dreams of doing other things,” said Grayson Armstrong, MD, MPH, a chief resident in the Department of Ophthalmology at Harvard Medical School who was elected to the AMA Board of Trustees in June 2019.

Dr. Armstrong had become interested in health care accessibility while in medical school. He wanted to continue working in public policy during his residency, but he knew that would require time in Washington.

“I started asking around, and only a few ophthalmology programs were receptive to the idea of my exploring other interests,” he said. “Some of them seemed to be confused by why I would want to do something like that. It seemed superfluous to what they wanted in a resident. But in the end, it helped me commit to my career goals. It was a big factor in how I ranked programs.”

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Tyler Andre, MD, is an emergency medicine physician in Richland, Washington, who was formerly chief resident of the emergency medicine program at Western Michigan University School of Medicine. After growing up in California and attending medical school there, he hardly expected to end up in southwestern Michigan—in Kalamazoo—for his residency. But he found it to be a good fit with his family and his personality, so he made sure to include the Western Michigan program in his ranking.

“Emergency medicine is slightly different from some of the other residencies in that there are three-year and four-year programs,” Dr. Andre said. “Western Michigan is a three-year program, and I was married with four kids, so I thought if I could shave a year off, that would be great. Another thing I looked at was the cost of living. Not as many people care about that, but I did because of my family situation.”

“It’s very easy to think, ‘Everyone says this is the best program in the world, and you’re so lucky to interview there. How could you not rank it No. 1?’ That’s a very easy trap to fall into, because you’re in this rat race and everything’s competitive,” said Chirag Shah, MD, an anesthesiology fellow at the University of Illinois College of Medicine.

“You really have to get beyond that and think about where you’re going to be happiest. Because the best program in the world, according to the experts, might not be the best program for you.”

Dr. Shah also has offered advice on how to consider geography in your match rank-order listings and how to put together your loan-repayment checklist during residency.

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“I had gotten a lot of advice from people in my subspecialty, as well as people who were not in my subspecialty, advisors, mentors, friends,” said Matt Lecuyer, MD, formerly a pediatric emergency medicine fellow at Brown University, who went through Match twice. “The piece of advice that was really useful was to think back on every interview you had and your interactions with the faculty, the residents, your co-interviewees, and think about yourself being in that environment and with that group of people.

“Residency is the most intense, the most terrifying and the most amazing experience of your life. You might be moving across time zones or even across the country,” said Dr. Lecuyer, now an attending physician at Children’s National Hospital in Washington.

“So you need to know you’re going to have a support system, and I think that’s especially important now with concerns about resident and fellow burnout. You need to really focus on your own wellness and make sure you can see yourself with those people, because you’ll be spending more time with them than you will with your own family.”

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