The Do's and Don'ts of Rank Order Lists

After completing interviews for the National Resident Matching Program (NRMP) Match, program directors will create a list of the applicants they have interviewed, ranking them in order of preference. At the same time, applicants will submit a list of programs where they wish to train. This is called the Rank Order List (ROL).

Applicants are allowed to rank an unlimited number of programs, but extra fees will incur for each additional program ranked over the 20 included with the registration fee. For 2016, all applicants and programs can begin entering their Rank Order Lists on January 15th at 12:00 p.m. ET. All Rank Order Lists must be completed and certified by February 24th at 9:00 p.m. ET. A Rank Order List can be adjusted any number of times before the February 24th deadline, and can be re-certified if any changes, additions, or deletions are made.

Some tips for a successful ROL:

  1. Rank according to your TRUE preference, NOT where you think you are most likely to Match
    • The Matching algorithm is designed to place you in the most preferred program possible. Some people make the mistake of ranking their least favorite program out of fear that they will not match anywhere else. Do not be intimidated! As long as your favorite program ranks you high enough to match, you will have a chance to match. You would much rather have a chance in a place you’re happier working, than to rank in your least favorite program, just because it’s safe.
  2. Do NOT rank programs where you did not interview.
    • These programs will not rank you unless you interviewed there.
  3. Only rank programs where you will be happy to train.
    • Once you are accepted into a program, it is a binding contract for the duration of the program. It would not be in your best interest to go through a residency program where you are miserable. Remember, your happiness comes first!
  4. Consider the competitiveness of the specialties and programs you include in your ROL.
    • You should be realistic about your chances and include a variety of competitive and less competitive specialties and programs on your list, including a program you are most confident of matching into.
  5. Rank ALL of the programs where you interviewed.
    • Some people believe that ranking less programs will give you a higher probability of matching, but this is not the case.
  6. Do NOT delay submitting your ROL until the last minute.
    • It is likely that the servers will be overloaded and working slowly.

These tips are especially important for International Medical Graduates (IMGs). The 2013 NRMP Applicant Survey showed that unmatched IMGs were more likely to rank programs based on their perceived likelihood of matching compared to their matched IMG counterparts. As well, the unmatched IMGs were less likely to rank according to their true preference or to rank a mixture of competitive and less competitive programs and specialties. 7% of unmatched US citizen IMGs and 22% of unmatched non-US citizen IMGs declined to rank all programs at which they interviewed. In the 2013 NRMP Match, almost half of the IMGs who submitted rank order lists failed to match into a program.

Improved ranking strategies for all applicants in the Match can greatly improve their probability of matching, especially for IMGs.

References:
  • National Residents Matching Program. Results of the 2013 NRMP Applicant Survey. www.nrmp.org.
  • Liang M, Curtin LS, Signer MM, Savoia MC. Understanding the interview and ranking behaviors of unmatched international medical students and graduates in the 2013 main residency match. J Grad Med Educ. 2015; 7(4): 610-616.
  • Applicants: About Rank Order Lists. www.nrmp.org.