Tips for Submitting your NRMP Rank List

By: LifeofaMedStudent

After all the interviews, spreadsheets, back and forth late night thoughts- the Rank List has opened and it’s time to think about submitting. Here are a few tips to help you set your list – and forget about it until Match Day!

Rank List Basics:

It is important to know a few basic details about the Match. First, the applicant’s (YOU) side of the ranking is what the match starts with. Here is how the NRMP describes the process: “If the applicant cannot be matched to that first choice program, an attempt then is made to place the applicant into the second choice program, and so on…” This must be remembered because (discussed later) what you think the programs might rank you should not be considered at all. In fact, it is possible to rank programs for which you did not even get an interview at, though, I’ve never positively heard of a match this way.

Another important point along that line – your rank list is yours and yours alone. “Your rank order list is confidential and never will be shared with the programs. You are the only person, other than NRMP staff, who can access your ROL unless you give your username and password to someone else.” Do not worry about programs finding out where you ranked them. However, program directors do talk, and I strongly would not recommend telling more than one program you intend to rank them 1st – this is a poor look and poor professionalism that could come back to haunt you.

Lastly, once you certify your list you can make changes to it. Unlimited changes, actually. “…your rank order list can be modified or re-ordered any number of times until … Certification Deadline, but no additions, deletions, or changes can be made to your rank order list after the deadline. If you change your certified ROL by adding, moving, or deleting a program, you must recertify it for it to be used in a Match.” My advice here is simple – set it and forget it. Spend as much time as you need to get it right, but once you are confident enough to certify, let that be the final version unless something drastic changes.

Now some general tips for making your rank list….

Stay true to yourself.

You’ve spent months going over and over the different program options: Academic or community? Small or large-sized program? Clinical experiential learning or more focus on didactics for education? Big city or smaller? How much does geography matter? Do you want to do research – which programs encourage this? You probably have a preference for each of these. You know which answers are important to you. Now time to try and line that up with the programs you’ve seen. It’s not easy, but if you absolutely hate didactic learning, you probably shouldn’t list a program that does this daily in your top three – no matter how great the interview was. Even if a program has an amazing research reputation – it shouldn’t matter highly if you aren’t interested in doing research. Stay true to what you know really matters to you as you fill out the list!

For me, geography ended up playing the biggest role. I’m a Midwest guy and never could picture myself on either of the coasts. So most all of my interviews were within driving distance from Indiana, with the exception of one in Florida and one in South Carolina. I knew being semi-close to my family was as important to me as any of the other factors, and stayed true to that as I interviewed and ranked.

Ask friends and family for advice – but be prepared to ignore it.

Advice from those close to you I can be very helpful, especially family and longterm friends. Many of those know us well enough to help sort through the stress of the match process and decided what is important to us. Can we be happy in a smaller community if we’ve always loved the city? Should I rank stay closer to home? Family and friends can be great second opinions for many of these hard choices. But like the first piece of advice above, at the end of the day, you have to stay true to what you know is important for your goals and education.

Ask significant others for advice – and be prepared to accept it.

For those of you in serious relationships or married, the match can be exceedingly stressful. These education goals must also be balanced with relationship goals – no easy task. At the end of the day, if the relationship is serious enough – the significant other should get a say in how the next 3-5 years of their life could go. And if it’s serious enough to ask, you need to be prepared to accept their answers for preferences on geography, cities, or significant other job prospects.

During my interview process, my wife (then girlfriend) and I had only been dating about 6 months. This was long enough to know we had something serious growing but short enough it was hard to flat out change my thought process. Luckily, she valued family as much as I, so ranking closer to home was agreeable for both of us… and the rest, as they say, is history.

Don’t rank somewhere you absolutely would not want to go.

If you were like me, you probably interviewed at a program or two that you feel you’d rather not end up at. If you feel that strongly, I would highly suggest not ranking that program at all. Yes, you are essentially saying I would rather NOT match (and have to scramble/SOAP) than go here, but sometimes that’s not actually the end of the world. To elaborate, a story of a friend of mine: He was slightly below average anesthesia candidate and didn’t get many interviews. In fact – because he was very picky about where he’d want to go – he only ranked 3 places, despite having several other options at programs he simply found undesirable. He stated at the time, he’d rather scramble and compete for the unfilled spots if it came to that than go someplace he KNEW he wouldn’t be happy. So the match day comes and the result? He scrambles into an excellent program (one I personally applied to but was not offered an interview) that could be argued is better than any of the programs he originally interviewed with and definitely better than the few others he turned down in the ranking. Now not every example of this will work out so well, but I still think my original point is true: don’t rank places you simply do not want to go!

Do NOT consider how you think programs will rank you in making your list. Ignore post-interview communication.

This is the biggest one. Yes, you will have hints that you are more competitive with some programs versus others. Some programs even come out and fairly aggressively let their top choices know they are planning on ranking them highly. Other programs will send out generic emails prior to match rank lists to everyone, regardless of how they plan to rank them. I personally, had variations of all three, with some strongly suggesting I was among their top choices, while others were more generic. One program I sent an “intent to rank highly” email sent me back essentially a “thanks, but good luck” email that immediately gave me the impression it was a “no” from them. I appreciated the positive emails, and honestly, the less enthusiastic ones stung a bit. But I kept my list true to what I wanted and did not increase or decrease a program’s position based on the feeling I got from any post-interview communication. Even the one I essentially felt was a no – I ranked #3 as I had always planned. If you were granted an interview, you are likely on the program’s rank list – where there is always a chance. Don’t make the mistake of downgrading a program you like just because you think your chances aren’t as strong.

*I said “I love you”… this program said “Best Wishes”.. but I still ranked them the same.*

And that is the bottom line – your rank list should stick to an order of what you want, and other than very serious significant other input – be true to your residency program desires. Now go set your list and get it off your mind until Match Day! Best of luck to you all!!

Read other Residency Tips from the series here:

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