The methods to making a Match rank-order list are highly individualized. The factors an applicant values in a residency program are going to vary widely. Still, there are common themes, and, thus, a few common mistakes that students make.

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Eric Strand, MD, is associate professor of obstetrics and gynecology and the director of 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 3 rank-order list deadline looming for the 2021 Match, Dr. Strand offers cautions on a few common missteps to avoid in ranking programs.

Getting all the information you need on a program may be more difficult during a disrupted 2021 Match cycle. Students have not had opportunities for away rotations and in-person interviews due to travel restrictions stemming from the pandemic. 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’s no harm in asking program directors, other faculty, or residents for direction.

Dr. Strand says 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.”

Learn why you should trust your gut when it comes to Match rankings.

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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—Strand says 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 that’s fine. But when you have interviewed with a place and you leave them off that’s essentially what you are saying.”

Learn with the AMA how residency programs will view applications in 2021.

Programs may reach out to you after an interview with what sounds like positive messaging, and the National Resident Matching Program (NRMP) allows for interviewers to “freely express their interest in a candidate.” Still, any sort of post-interview correspondence, Dr. Strand said, should be taken with a grain of salt. 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.

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 a number of ways.

“Those sorts of vague comments are very open to interpretation,” he said. “We don’t, as a program, do any communication like that. It’s too fraught with trouble for a potential misunderstanding. I don’t want to take a chance of misinforming a student.

“If a student came to me and said ‘Hey, I got this email from a program, what does this mean?’ I would say, ‘I don’t know that it means anything. Maybe it means you are in the top third, maybe it means you are in the top half, maybe they send it every one of their applicants.’”

Find out which factors applicants weigh most when picking residency programs.

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If you feel like your dream program is a reach, but 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.”

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, rotations and other events at this time.

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