How to Make Your Residency Rank List

You’ve spent countless hours pouring over every word in your ERAS application and personal statement, you’ve traveled far and wide to be wined and dined and interviewed, and you feel that you’ve taken one too many hospital tours in the past few months. Well, congratulations, you’ve made it through the hardest part of the residency application process! Now, the fun begins…here are some tips on making your rank list.  

1. Priorities, priorities, priorities!

First off, decide what is most important to you. Is its geographic location? Or are you more interested in the prestige and reputation of programs? Or rather, does the diversity of the patient population matter most to you? Or do you prioritize a program where you feel that you engaged well with the current residents and staff on interview day? Find the top one or two things that matter most to you in both your professional development and your day-to-day happiness, and create your rank order based on those factors.

2. Once I’ve decided, Should I tell a program I’m ranking them #1?

DEFINITELY, YES! Residency Program Directors are motivated to match their top-ranked applicants. If they have a guaranteed person who is definitely going to come, and if they like you, this is a win-win situation.

However, only tell a program you are ranking them #1 if you are in fact doing so. If a program ranks you highly and you told them you put them number one, but you don’t end up matching there, this may trigger serious questions and your behavior may be called into question. Often, the program you slighted will call the program where you matched and let them know about this extremely unethical behavior, which is not a great way to start your residency.

3. How do I tell the program they are #1?

If you know your top choices beforehand, you can bring this up during your interview with the residency program director. Read the room. It should be relatively obvious from the get-go if the residency program director is very interested in matching you – they will try to sell the program to you. In this situation, bringing up that you will rank them #1 is relatively straightforward.

If you decide later on after you’ve completed all your interviews that you are ranking a program #1, reach out to the program director via email, explicitly stating that they are your #1 program. You may even very briefly reiterate your interest in the program and why you think you would be a good fit.

4. Other types of post-interview communication and what to make of them

Note that residency program directors are legally forbidden to saying something along the lines of, “We will rank you #1 if you rank us #1.” The discussion about ranking a program must be initiated by you as the applicant.

Programs may reach out in some other way after the interview is over, usually something generic to the effect of “we would be lucky to match you” or “we were all very impressed by you on your interview day”. Often times, these are statements they make to many interviewees. Therefore, try not to let these statements sway the formation of your rank list. The algorithm of the match favors the applicants. As a result, make your rank list based on the order of the programs YOU desire, and not based on where you think you will match.