Ranking Residency Programs

I cannot believe I am writing that residency interview season is already half over! At this point I have met 40 of the 80 candidates our residency program will be interviewing, and while I contemplate our program’s strategy for ranking candidates, it prompts me to consider candidate strategies for ranking programs.

Most candidates are quite candid with their decision to rank our program number 1 on their rank list (or so they say ☺); however, they additionally seek consult from me regarding recommendations on how to rank other programs they have interviewed at that fall somewhere ‘in the middle’ of their rank list.

Selecting your favorite program is often an easy selection, but what happens after you determined the program that receives your coveted first rank position? This is a personal decision for each applicant; however, I have a go-to list of considerations that I share when asked about how to rank residency programs in the Match.

1. Own your Match list. Consider the feedback you have received from programs and your overall desire to be in that program, and go where you want to be.
2. Ask yourself, “Do you see yourself as a resident in that program?” After meeting with faculty and residents, touring facilities, learning the standard curriculum – do you fit in and feel excited about the prospect of learning in this environment? This is a very intuitive experience unique to each person, and only you will be able to answer this question.
3. Current Residents – Do they look satisfied with their residency experience?
4. Location – How important is the location to you? Considerations include proximity to family and support system, rural vs. urban, community vs. academic setting preferences.
5. Academic Vigor – Consider the potential for research, weekly conference topics, specialty tracks, faculty’s passion for teaching.  
6. Salary and Benefits – Will you make enough money and receive benefits that you require to sustain your basic living needs through residency?
7. Learning Environment – Some of your best questions on interview day should relate to the topic of learning environments in each program. What does the day-to-day learning look like in each program, and how is this provided to residents? Also consider how the program will prepare you for your specialty board exam. Do they have formal didactic sessions every week that focus on board preparation or is the majority of their didactic time focused on other research endeavors? This question can be easily answered by asking for the program coordinator to email their syllabus or lecture calendar. It may not matter to you now, but this is extremely important to know as your time will be strained between patient care, documentation responsibilities, and other roles. You want to make sure any time dedicated to didactics focuses on helping you pass your specialty board exam.

If it is truly a toss-up between one program vs. another, I highly recommend considering the request for a second visit. Most programs encourage interested applicants to make second visits to observe precepting in the outpatient setting, and/or to observe inpatient service team dynamics.

Overall, the reality is that the Match algorithm favors candidate rank lists over program rank lists. Because of this you should feel confident and OWN your Match rank list. Consider the feedback you have received from programs and your overall desire to be in that program. Go where you want to be.

– Jillian Atherton, Residency Specialist

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