Considerations & Strategies to Optimize Your Final Rank List

  • /Reviewed by: Amy Rontal, MD
  • Pat yourself on the back. As interview season draws to a close, you can take a deep breath and relax; You’re done dressing up for zoom meetings, watching virtual tours and can finally enjoy the chill MS4 year you were promised. However, as an applicant, your job’s not quite done yet and finalizing your rank list might remain a challenging end to the journey. Everything you’ve done has led you to this point so take in these considerations before you submit your rank list.
    The obvious tip is to simply rank the programs in the order you’d like to attend them. Residency is a minimum of three years, so naturally, you don’t want to rank any programs that would make your life miserable. Maybe something about the program left a bitter taste in your mouth on interview day, or maybe you’re a city guy/gal and can’t see yourself living in a small town. In either case, if you can’t see yourself happy there for a year, rank it lower or not at all.
    If you and your partner have planned to couples match, rank the same programs first, followed by those that are close geographically. The algorithm works so that if both applicants fail to match their first choice, the next set of paired programs in the list are considered.
    Certain specialties like PM&R, dermatology, radiology, and some surgical subspecialties require a preliminary year. The prelim year is often medicine or surgery but the lucky few can have a TY or transitional year. For ERAS, you will need to rank your advanced programs along with your prelim programs, which may be two separate locations so be sure to keep that in mind.
    Here’s a list of considerations from most important to least which helped me choose my program. Spoiler alert, I recently graduated and loved my time in residency, so much so that I served as chief resident my final year!
    1. I couples matched, so I ranked ONLY places both my partner and I wanted to attend.
    2. Major U.S. City: This is what determines training volume, acuity and variety. I’m from Dallas and have grown accustomed to the convenience of city life.
    3. Programs with more than 6 residents per class: the more the merrier, I enjoy being social as well as diversity in programs.
    4. A university program that encourages teaching and residency wellness. Emphasis on wellness prevents burnout…hopefully.
    5. Opportunities for fellowship within the institution as well as previous grads going into fellowship. I had considered a sports medicine fellowship for a long time.
    6. No red flags – I had an interview at a program where the PD never showed his face. That same year, the hospital got bought out by private equity and shut down its residency program.
    There’s a lot that goes into a residency experience. Every applicant comes from a unique background and has different reasons for going into medicine and what he/she wants out of residency. Determine which aspects are most important to you and set your rank list accordingly. Good luck!