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How to rank programs in the residency match

The moment of truth! Let’s talk about ranking programs after interview season. If you’re couples matching, see our post on the couples match.


Should you send an email to your top choices?

This is controversial and should only be done if it is your final rank list decision. We do recommend sending an email to your #1 ranked program. We sent emails to our respective #1 programs informing them of their position at the top of our rank list. This is taken fairly seriously by programs and should only be done if true and should only be done for a single program. Programs do speak with one another and the last thing an applicant wants is for two programs to blacklist them for this issue. We found that sending immediate thank you emails after our interviews showing our interest was very well received and was not misleading to programs.


For some people, coming up with their top choices is very easy. For others, they have a hard time deciding. We had an easy time coming up with our top 3, but coming up with the full rank list was more difficult as we got further down. Our best piece of advice--go with your gut! Think back to the interview day: did you get along well with the residents and did they interact well with each other and their faculty? Would you enjoy living in that location? Will that program give you the best training possible? All of these aspects are important but the order of importance of these factors will depend on the person.


For us, location was very important, but was not a dealbreaker. Luckily, our favorite programs happened to be in the location that we wanted. The personality and culture of the program were traits we valued highly in our decision making because we wanted to ensure we would be happy and would enjoy the people we would be working with. Other important factors to consider: diversity/complexity of pathology, amount of cases/procedures, prestige, lifestyle, cost of living, etc. Notes that you kept from interview day can really help you here if you’re stuck between a few programs!

Note: if you use Reddit/SDN, there can be very polar (and often inaccurate or inflammatory) opinions on certain programs, so be aware of that. We did our best not to look at Reddit because it ended up being counterproductive.


In general, most places will provide great training and there are frequently only a few things that set programs apart. It is important to be specific with your preferences because certain programs will seem identical on paper, but differ more once you delve deeper.

We would encourage you to watch the videos on the match ranking on the NRMP website that show you how to rank with their software. These are very helpful, especially for applicants who have preliminary/intern year programs to rank as well and/or are couples matching. It can be confusing! Also, it’s a good idea to print out a hard copy right before you submit in case anything goes wrong.


If you only retain one thing from this post it would be this: rank the programs in the order that you like them! There is absolutely no benefit in trying to outsmart the match and rank in an order that you think programs will rank you. It can and will hurt you. The match works in the favor of the medical student. For instance, if you like program A better than program B and A decides to match you, then you will match to program A. However, if program A does not rank you to match but B does, then you will match with program B and you will have at least given yourself a shot to match with program A. If you had put B first even though you didn’t like it more than A since you thought you had a better chance of matching there, and A had ended up ranking you to match, you would have missed out on program A just because you tried to outsmart the system (this is important: go back and read this again!). This all sounds confusing but it will make more sense when you do it yourself, we promise!


May the force be with you!

--C&W

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