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  • Writer's pictureDr. Samir Desai

Rank-Order List Errors: 3 Rules To Prevent Disaster In The Residency Match

If you're a residency applicant, you've nearly come to the end of a grueling process. To recap, you agonized for weeks about your personal statement, pored over your application again and again looking for typos, applied to countless residency programs, practiced answering hundreds of interview questions, and spent thousands of dollars to traveling from one program to another.

Now there's one final task left: the creation of your rank list. Errors made at this last step in the process can be disastrous. In fact, the AAMC has identified rank order list errors as one of the top 7 reasons why applicants fail to match.

To avoid missteps, stick to the following 3 rules:

  • List every program you would be willing to attend. The only program or programs you should not list are those where you would be miserable. Before removing "miserable" programs from your list, ask yourself one important question. "Would I rather go unmatched than match with this residency program?"

  • Rank programs in order of desirability. Which program did you like the best? Rank that program first, followed by the program you liked second best. Then keep going in this manner until you've ranked all programs. One more point to add. Don't let love letters from programs affect the order in which you rank programs.

  • Make your rank list long. The longer your list, the better your chances of success.

These strategies are endorsed by the NRMP based upon research performed on an applicant's chance of matching with their preferred residency program. Despite being widely publicized, the evidence indicates that applicants often do not follow these recommendations.

In a study of the ranking behaviors of matched and unmatched international medical graduate (IMG) applicants participating in the 2013 NRMP Match, both groups were found to make major errors. Among unmatched IMG applicants:

  • Only 61% ranked all programs at which they interviewed

  • Only 40% ranked all programs they were willing to attend

Among matched IMG applicants:

  • 20% ranked the programs based on the likelihood of matching

  • 6.5% did not rank programs in the order of their preferences

Although the study focused on the ranking behaviors of IMG applicants, I have seen these same mistakes made by allopathic and osteopathic students. Adhering to the above recommendations will ensure that you don't jeopardize your chances at this final stage in the process.

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