How to Rank Residency Programs? Your Guide to Making Your NRMP Rank Order List

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How to Rank Residency Programs?
Your Guide to Making Your NRMP Rank Order List

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A key component of the residency Match process is the rank order list, a carefully considered list of residency programs ranked based on your preferences.

Crafting a thoughtful rank list is essential for both a successful Match outcome and setting yourself up for future success in your postgraduate training. This process determines where you will spend the next 3-10 years of your training (depending on your specialty).

In this blog, we will discuss the different factors you should consider when building your Rank Order List.

How Does the Match Algorithm Work?

The National Resident Matching Program (NRMP), or “The Match,” uses a computerized algorithm to place applicants into residency positions. Your rank order list is your way of telling the algorithm your program preferences. The programs rank applicants as well, and the Match is the result of this mutual ranking system.

Understanding the mechanics behind the Match can help demystify the process and aid in strategic ranking.

Importantly, it is imperative to remember that the Match Algorithm is “applicant-proposing” meaning the preferences expressed on the rank order lists submitted by applicants, not programs, initiate placement into training.

In other words, when creating your rank list you should truly rank programs in your order of preference (as opposed to ranking programs highly that you think will rank you highly) as you will not be penalized.

To understand this process more, you can watch these two videos: Video 1, Video 2.

Interviews and the Rank List

As you navigate through the interview season, the impressions and experiences from each program can start to blend together, making it challenging to recall specific details later on. To counter this, it’s crucial to develop a habit of taking detailed notes immediately after each interview.

Document the pros and cons of the program, your gut feelings about the culture and environment, and any specific interactions with faculty and residents that stood out to you. These notes will be invaluable when it comes time to create your rank list, helping you to remember not just the factual aspects of each program, but also your personal reactions and feelings towards them.

This process ensures that your final decisions are informed not only by objective criteria but also by your intuitive responses to each program, providing a holistic view that can guide you toward the best fit for your residency training.

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Before You Start Ranking

Reflect on what matters most to you in your residency training and beyond. Consider factors such as the type of clinical exposure, the culture of a program, geographical location, and lifestyle. This self-assessment will serve as the foundation for evaluating and ranking programs. Seek input from friends, family, and mentors as this is a big decision.

How to Evaluate Residency Programs? Factors to Consider When Making the Rank List!

Academic and Educational Opportunities

The academic and educational framework of a residency program is fundamental to your development as a physician. Pay attention to the following aspects:

  • Curriculum: A thorough understanding of the program’s curriculum is crucial. It should offer a balanced mix of clinical training, didactic learning, and elective opportunities to cater to your educational needs and career aspirations.
  • Faculty and Their Subspecialties: The diversity and expertise of the faculty can significantly enrich your learning experience. Look for programs where faculty members are leaders in their fields, offering mentorship and exposure to various subspecialties.
  • Research Opportunities: Active participation in research can be a pivotal part of your residency experience. Evaluate the availability of research opportunities, including support for projects and access to resources.
  • Research Year: Some programs offer or require a research year. Consider the benefits of dedicated research time, such as the potential for publications, presentations, and the development of a strong research skill set. Investigate the labs and mentors available to support trainees during this year.
  • Recent Graduates’ Success: The achievements of recent graduates, especially in terms of fellowship placements, can provide insights into the program’s strength in preparing residents for advanced training. A track record of successful matches into competitive fellowships is a positive indicator of a program’s academic environment.
  • Types of Fellowships: While evaluating a program’s success in fellowship placements, consider the diversity of specialties. A program may be strong in matching graduates into certain subspecialties (like cardiology) but not others (such as GI or Heme/Onc). This could align or conflict with your long-term career goals.

Rank List Advising

Get expert advice on how to rank your residency programs from our advisors. Get your money back if you are not satisfied.

Clinical Experience

When assessing the clinical experience offered by residency programs, several factors play a crucial role in ensuring comprehensive training. Consider the following:

  • Type of Hospital: The hospital’s level, such as a Level 1 Trauma Center versus a community hospital, impacts the complexity and variety of cases you’ll encounter. Level 1 Trauma Centers typically offer a broader range of high-acuity cases.

  • Location: The hospital’s location, whether urban or rural, influences the patient demographics and common conditions treated. Urban centers may offer exposure to a diverse patient population, while rural settings can provide unique primary care experiences.

  • Academic Affiliation: Programs affiliated with academic institutions often provide opportunities for research, teaching, and exposure to cutting-edge treatments and technologies.

  • Types of Cases and Pathologies: The variety of cases and pathologies you see is crucial for a well-rounded training. Consider programs that offer a balanced exposure to both common and rare conditions, tailored to your specialty.

  • Volume of Cases: The volume of cases is indicative of the hands-on experience you’ll gain. High-volume centers can offer extensive procedural experience, which is critical for specialties requiring technical proficiency.

  • Catchment Area of the Hospital: The hospital’s catchment area determines the diversity of the patient population and the range of conditions treated, affecting your learning experience.

  • Types of Rotations: Evaluate the breadth and depth of rotations offered. Some programs may be strong in certain areas (e.g., trauma surgery) but have limited exposure in others (e.g., surgical oncology). Ensure the program provides a balanced experience or aligns with your interests.

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Program Culture and Environment

The culture of a program significantly affects your training experience. Seek programs where you feel supported, where mentorship is strong, and where residents are satisfied with their education and work-life balance.

During the interview process, most programs will disclose specific factors regarding the program such as call schedule, rotation schedule and the flexibility to incorporate electives into your education. These are important considerations that may factor in your reasoning for ranking a program higher or lower.

Salary and Benefits

Salary and benefits are yet another consideration when creating a rank list. This information can be found online and is typically universal for the entire healthcare system regardless of specialty (although there are some salary incentives for Family Medicine and Rural Medicine Programs).

Consider both the salary and the cost of living in that area as $70,000 is very different in Boston vs. rural PA. Finally, you should also see what additional benefits are provided, this includes health insurance, childcare, fertility care/counseling, and retirement benefits.

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Opportunities for Professional Development

A residency program’s commitment to the professional growth of its residents is a critical factor to consider. Opportunities for professional development not only enhance clinical skills but also prepare residents for leadership roles in their future careers. When evaluating programs, consider the following:

  • Discretionary Education Funds: Some programs provide residents with a budget for educational resources, allowing them to attend conferences, purchase textbooks, or subscribe to professional journals. This financial support is crucial for staying current in your field and networking with peers.

  • Funding for Medical Supplies: Look for programs that offer funding for essential medical supplies, such as surgical loupes, stethoscopes, and handheld ultrasounds. These tools are fundamental to your training and can enhance your learning experience.

  • Internal Educational and Research Conferences: Participation in these conferences can significantly enrich your educational experience. They provide a platform for presenting research, engaging in academic discussions, and learning from peers and experts in your field.

  • Visiting Professorships: Programs that invite visiting professors offer residents the opportunity to learn from renowned experts. These experiences can introduce new perspectives and techniques, broadening your educational experience.

  • Workshops Focusing on Hands-on Techniques: Hands-on workshops are invaluable for developing and refining technical skills. Look for programs that offer workshops in advanced procedures, simulations, and other practical skills relevant to your specialty.

  • Mentorship and Career Guidance: A program that facilitates strong mentorship relationships and offers career guidance can have a profound impact on your professional development. Mentorship can provide you with personalized advice, support, and opportunities for career advancement.

Rank List Advising

Making your rank list is a stressful task! Our advisors have extensive expertise and can help you make the best decision on where to spend the next 3-10 years of your life.

Diversity, Equity, and Inclusion

A residency program’s commitment to diversity, equity, and inclusion is crucial for fostering a learning environment where all individuals feel valued, respected, and supported. When evaluating programs, consider the following aspects:

  • Diversity Statement and Policies: Look for clear statements and policies that reflect the program’s commitment to diversity. This includes efforts to recruit and retain a diverse workforce of residents, faculty, and staff.

  • Inclusive Environment: Evaluate the program’s environment to ensure it is inclusive and supportive of all individuals, regardless of their race, ethnicity, gender, sexual orientation, religion, or socioeconomic background. This can often be gauged through discussions with current residents and faculty during interviews or visits.

  • DEI Initiatives and Resources: Investigate the specific initiatives and resources the program offers to promote diversity and inclusion. This may include mentorship programs, diversity committees, cultural competency training, and support groups.

  • Representation: Consider the diversity of the program’s leadership, faculty, and resident body. Representation matters, as it contributes to a richer learning environment and provides role models for all trainees.

  • Community Engagement: Programs that engage with their local communities, especially underserved populations, demonstrate a commitment to social responsibility and health equity. Look for opportunities to participate in community service and outreach activities.

  • Support Systems: Evaluate the support systems in place for residents, especially those from underrepresented backgrounds. This includes access to mental health resources, professional development opportunities, and networks for personal and career support.

Location and Lifestyle

Consider the impact of location on your personal life and well-being. Factors like cost of living, proximity to family, and lifestyle opportunities should align with your long-term satisfaction and happiness. 

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Ranking Strategy

Balance is key when creating your rank list. Consider each program’s strengths and how they align with your priorities. Be honest with yourself about where you see the best fit.

Again, because the Match Algorithm is applicant-proposing, your rank list should reflect your true preferences. Don’t be afraid to aim high.

How many programs should I rank for residency?

You can rank as many programs as you like. Generally, it is recommended to rank only the programs you interviewed at. Do not rank programs you don’t want to match at (not a good fit for you).

When is the Deadline to Submit and Certify the Rank List?

For Match 2024, the deadline to submit and certify the Rank List is FEB 28 09:00 PM EST.

Finalizing Your Rank List

After thorough research and reflection, revisit your list with fresh eyes. Seek input from mentors and peers but remember that the final decision should reflect your own preferences and judgment.

Finally, trusting your gut feeling about a program’s fit can be just as important as its academic credentials.

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Common Pitfalls to Avoid When Ranking Programs

Avoid common mistakes such as ranking programs based solely on prestige or underestimating the importance of program culture.

Remember, the goal is to find a program where you will thrive, not just survive.

Finally, it is important to realize that you do not have to rank every program that you interviewed at. If there is a program that gave you particular bad vibes or came across particularly malignant it may be in your best interest to not include it on your rank list as this is a legally binding commitment

Conclusion

The Match is a unique and complex process but approaching it with a well-considered rank list can significantly increase your chances of a positive outcome. Remember, this is about finding the right fit for you, where you can grow, learn, and become the physician you aspire to be.

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You interviewed at multiple programs and are not sure how to rank them? Our advisors are here to help!
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