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Ranking residency programs: Tips for ordering your list

Evaluating residency programs can be stressful. But building a rank list helps medical students reflect on their goals and how residency can get them there.

When I submitted my residency application last summer, I thought I had a clear idea of how I would rank programs. I was wrong. As soon as I started going on interviews, I realized that there was depth and nuance to each program that I would need to factor into my decision-making. By the time the holidays came around, I was neck deep in building a rank list; as an ophthalmology applicant, mine was due in early January. Every day, I oscillated back and forth, moving programs up my list and back down moments later.

While I was able to sort residencies into tiers of preference, I struggled to arrange them within those tiers. I ultimately came up with a list I liked and am happy with the result. With National Residency Matching Program rank lists due in just over a week, I want to share some of the lessons I learned in evaluating residencies.

Identify the factors that matter to you: Professional opportunities, including clinical volume, research projects, and fellowship match/job prospects, are paramount in building a rank list for some people. For others, personal factors such as a significant other, geographic preferences, or quality of life considerations take precedence.

Identifying what is important to you is a necessary first step in making a rank list. When I asked others for advice, it inevitably came through the lens of their priorities. Without my own framework to filter those comments, I would have become lost and confused in ranking programs.

Find a balance between “going with your gut” and being systematic: One of the most common pieces of advice I received was to “go with your gut” in deciding between programs. The logic is that your intuition and reaction to the faculty and residents you meet is the best barometer for a good fit.

In my case, my gut told me that I would be happy at almost all of the places where I interviewed. I therefore took a systematic approach and built a spreadsheet. I gave each program a rating based on all of the criteria that I previously identified. I then weighted the criteria based on their relative importance to me. After multiplying the ratings by the weights, I had an initial ranking of programs. I subsequently modified it but the spreadsheet gave me a semi-objective starting point, which was helpful.

Gather as many perspectives as you can: Although I had both my gut reactions and a spreadsheet of preferences, I felt like I needed more information to fully assess my options. It’s difficult to get a complete impression of a residency from conversations on a single interview day.

So in the two weeks between finishing interviews and submitting my rank list, I spoke to as many people as possible about the decision. I talked to peers going through the application process with me. I asked family and friends outside of medicine how they would think about it. And perhaps most importantly, I spoke to mentors who could provide a deeper perspective on the strengths and weaknesses of various departments. Sometimes I received conflicting advice but the information and reasoning behind that advice still proved to be valuable.

The Match is a stressful process but it’s worth remembering that there are a lot of great programs. More than anything else, then, building a rank list is an opportunity to reflect on your goals and how residency can get you there.

Photo via Pixabay

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category

Akhilesh Pathipati is a fourth-year MD/MBA student at Stanford. He is interested in issues in health care delivery.

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