The day is soon coming when you will find your one and only. Your destiny. The one you were meant to be with. The partner that will give you everything you hoped and dreamed for.
No, I am not talking about Valentine’s Day, I am talking about Match Day! The day when you find out where you have matched and where you will be doing residency training for the next 3, 4, 5 or 6 years. But before you get to that point, you need to submit your rank list. That day is coming much faster. Rank lists for the Class of 2016 are due on February 22nd, 2017 at 9pm EST. That means that you need to have your list of potential programs in the system and certified by then. Technically you first need to be registered for the Match, but I am pretty sure that you all already are. Right?!
Sometimes, students get concerned when they see the “Certify” button. They worry that it makes the list permanent and that they cannot change it. However, that is not the case. If you change your mind after certifying, you just have to go back into the R3 system make your changes and then “recertify” your list. To be honest, it is a good idea to go in there now and have a list made and certified. You never know if between now and February 24th you might get stuck in a well, get marooned on a deserted island or get sucked into an Internet rabbit hole of really catchy cat videos. But seriously, even if you are a procrastinator like me, no reason to wait to put a rank list in until the very last minute. you can always make changes and the system will probably be really slow on February 22nd as everyone will be on the system.
The biggest question I get this time of year, is how should I put together my rank list? What is the best strategy to match at the place I really want to go to? There has to be a trick or a secret or something. Unfortunately, this is no Jamba Juice or Starbucks or In-n-Out Burger. There is no trick, there is no secret menu or secret strategy. There is just this: Put the program you like best at the top of the list, put the program you like the least at the bottom, put all of the others in order in between there. (This is for people going through the Match solo. If you are in a Couples Match, there actually is a bit more strategy involved which is not within the scope of a blog post. If you have questions, I am happy to talk about it with you in person.)
Often times there are rumors or false information that you can hurt yourself if you put a “dream” or “reach” program at the top of your list that you don’t have much of a shot to get into. That somehow while trying to first match where you had little to no chance, your second, third and fourth choices would get filled up while you were futilely wasting time in line for your dream. This is most definitely not true. You should not be trying to guess what program likes you the most. You do not have to both put each other number one to match at your top program. The Match Algorithm is tilted towards the students. It will try to match you at your first choice, then second choice and so on until you have a match or until you are out of options. This video from the NRMP does an excellent job of explaining how the Match actually works.
So how do you preference programs? That is a very individualized question. Think about what factors are most important to you. Think about which programs fulfill those needs the best. The quality of the educators, the learning culture, the extras available to you (global health, advocacy/service experiences, research experiences) and other less tangible educational components are a big consideration. However, remember that not all of the factors you consider have to be about the education components of the programs. The ACGME regulates residency education, so the educational experience at at most every place will at least be good enough to get you to be board certified. Anything else you deem important to you is a legitimate reason to grade programs. Things like geography and availability for you to nurture other parts of yourself in that city (the art scene, bike-friendly town, presence of major league sports teams) are reasonable things to consider besides program specific/residency specific factors. For example, when I was ranking programs 12 years ago, I knew my top 2 choices and I knew my least favorite choice. After that I had a handful of programs that all seemed about the same in pretty much every major factor and I had no idea how to decide between them. So I literally decided between those middle programs based on which ones offered free parking and which ones didn’t. I wouldn’t suggest basing my top choice on something like that, but when everything else seems exactly the same, some times it is the minuscule differences that matter.
One final thing to remember is that the Match is binding. When you open your envelope on Match Day, you are required to go to the program to which you get matched. Even if it wasn’t a program you liked very much. Even if it was the last place on your list. Even if it was a place that you hated. So, it is very important to consider the bottom portion of your list as well. If there is a place that you visited that you despise for some reason, that is so awful that you would rather be unmatched than go there. If it is that bad, then do not include it on your list. This is an important thing to consider because not ranking a program is a big deal. It is another place you could match that you won’t be able to if they are not on your list. So to me that is the final question to ask yourself, “Would I rather be unmatched than go there?” If the answer is truly “Yes”, then do not rank them. There are very few places like that out there. More often it is due to intangibles like location or proximity to family. But being unmatched is a big burden, so you need to be sure.
The finish line is in sight. Match Day and Graduation Day are rapidly approaching. Making a rank list can feel very stressful, but in the end it is a relatively straightforward exercise. Figure out first what in general is most important to you and what you value in a residency experience. Then when you follow your values, the list will essentially make itself. Good luck and if you have any questions in this final stretch, don’t hesitate to ask!
