How to make a RoL:

This may be very easy for some, or may be one of the hardest things to decide in the entire residency application process. Remember, you can only rank programs you interviewed at.

Let’s start with some examples:

Applicant A interviewed at 3 places:

RoL: 1. University X
2. Uni-Affiliated Community
3. Community

That’s it for Applicant A. She ranked her only university program she interviewed at 1st, a university-affiliated community program 2nd, and a community program 3rd. She made her rank list based on academic institution, size, research and fellowship opportunities.

Applicant B interviewed at 10 places

RoL: 1. University X
2. Community
3. Uni-Affiliated Community
4-10: …

Applicant B placed University X as his number 1 choice due to its location. He placed a community program as his 2nd choice due to being in that same city as University X. Applicant B made his rank list based on location.

Applicant C interviewed at 5 places

RoL: 1. Uni-Affiliated Community
2. Community
3. University X
4-5: …

Applicant C placed the Uni-Affiliated Community program his first choice because when he interviewed there, the PD told him they will rank him to match. Afraid of not matching, Applicant C placed it as his number one choice. Applicant C made his rank list based on chance of matching to that program.

All 3 of these examples are very common. Applicant A and B made their rank lists correctly, prioritizing what matters to them most. Academic institution, research and fellowship opportunities are all important, while Applicant B choose location as a priority. Both are acceptable reasons. As for Applicant C, he misunderstood how the Match works and how he could benefit from it. Applicant C should have made his RoL in actual order of preference of the programs. He made it based on what PDs told him, which may have been said to every applicant.

Tip: never believe anything a PD tells you about where they will be ranking you (same goes the other way around if you tell a PD you are ranking them first; they hear it all the time)

When making your rank list, decide what is important to you and use that to formulate a list. If research and fellowship opportunities are important to you, rank those university programs highest which offer that. If you’d like to stay in your hometown and that is your number one priority, your highest ranked programs will start with the programs in that city or nearby. Once again, rank programs based on your actual order of preference.

Let’s say a program has showed extreme interest in you and you are sure you can and will match there if you rank them high. Use that to your advantage. Rank them at a place on your list where it will be a safety for you. Rank your best programs highest, place this program after, then place your backups which you are only putting in your list in case you do not match. This is using the match to your advantage. Though there is a less chance you may match to your top 3 (extremely competitive programs), you lose nothing in ranking them highest. The algorithm will go through each and every program from the top of your list till the bottom and try to match you to a program in that order of preference. Placing this safety program in between your top programs and bottom programs will hopefully save you from matching to your last ranked programs.

Now let’s say Program Z is your last resort. You have no intention in going there and it will be last on your RoL without question. Reconsider putting this on your RoL. Placing it on your list means there is always a possibility of you matching there. If your RoL has 10 programs, you have a good chance of matching to a program higher on your list, but if this program is 4th on your RoL, and that’s as far as your list goes, then there is a high chance that you may match there. If you are OK with that, leave it as is. If you do not want to go there and are only placing it so that you don’t end up not matching, really think about it. Do you want to spend the next few years at this place? Can you be happy with it? If this is also a backup specialty, can you settle for it? You have worked so hard to reach where you are today; are you fine with settling to this program? If you are, great. If you are hesitant, decide whether it is worth it or not. It may come down to matching at a place you do not want to be, or not matching and spending a year or longer building a resume for a better residency spot. Everyone has their own opinion so its up to you in the end.

Size of a program also plays a huge factor. The chances of you matching into a program with 5 spots compared to a program with 25 spots are completely different. Even though the program will interview more applicants for bigger programs, you have to look at how many spots are available for IMGs. 5 spots literally means 5 spots. They may take local applicants, their own medical students or ones who have rotated there, applicants they have worked with or are conducting research at that institute, or just people who have connections there. 5 spots go very quickly, especially if they only a couple spots are for IMGs. Now if a program has 25 spots, there are definitely more opportunities there for IMGs. If a program typically gives 10 spots for AMGs, 5 for DOs, and 10 for IMGs, your chances have gone up quite a bit. Research program sizes before applying! If you find out 20 of the programs you applied to only have 7 spots or less, some of which also go prematched, you may have wasted your money.

Tip: a lot of smaller community programs only accept local applicants / residents from that state. Many of these also go prematched.

Get advice on your Rank List!

So many people hide their RoL. They are either afraid of sharing, embarrassed, or just don’t trust others. Go to your seniors or someone already in residency in the U.S. and ask them what they think of your RoL. They may know something you do not about a program, good or bad. They may question why this program is higher than that? Getting free advice costs you nothing. This is your rank list so make it how you want it to be, but definitely seek some advice as this might be your first time making a rank list (and hopefully your last), so you do not want to screw up on it.

Submitting your RoL

Though this shouldn’t even have to be said, make sure you CERTIFY your rank order list upon completion. You can change the order of your list as many times as you’d like up until the deadline of RoL certification, February 23rd (may change every year). Not only should you double check every NRMP program code, double check it again because if one digit is off, you lost that program on your rank list (as if you did not interview and rank it). Also make sure it is the right program type, as some programs ending with a C0 are categorical, while P0 are prelim and M0 are primary care.

Registration for NRMP begins August 15th for $50 (both may change in coming years). Every applicant that wants to begin residency in June must register for the Match (exception: prematched individuals – might change in coming years).

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