After you’ve chosen the programs in which you are interested, sent in your application materials, and done an interview (if applicable), you are now ready to rank the programs. The rank order list is due in early January. What does it mean and how do you do it?
The mechanics of the match are described in detail elsewhere. Put simply, you rank the institutions and the institutions rank the applicants. Then an algorithm runs and matches the applicants with the institutions.
Some people try to over-complicate the match process. They think, “Well, I doubt I will get into place X, so I won’t ‘waste’ a high level spot for it.” Don’t assign value to the actual rank spot. Instead, you should rank purely on one criteria: Where do you WANT to go? Rank in order from YOUR highest picks to your lowest, without regard for your likelihood of them wanting you. The system is designed to be treated this way; you’ll mess up your chances if you try to second-guess the algorithm.
How many institutions should you rank? It depends primarily on how happy you can be in a given circumstance. For example, have you decided that literally the only way you can have professional fulfilment is to be a surgeon? First, I’m sorry for you. But if so, then you have to rank every single program. On the other hand, if you’ve decided that you would very much like to do surgery, but not at the expense of your physical or mental health, then you should only rank the programs where you would be happy. That’s difficult to know a priori, but it is possible if you do your research and talk to current or former residents.
The second consideration for number of institutions to rank is financial cost. There is a substantial step up from 10 to 11 institutions ranked ($90 to $250 in 2018). However, this is your future, the next step in the rest of your life. Even the highest step ($350 in 2018) is not particularly expensive, matched against your entire education to date and your professional future.
The next consideration is how good of an applicant you are. If you know you will be a top choice at a few schools, you only need to rank a few. If you are a good candidate but not sure where you stack up, you will want to hedge your bets and rank many more institutions.
The final and most important consideration is how to decide how to order your rankings. Being an analytical sort, I made a table. It looked something like this:
| Program | # Interns | Salary | Elective Time | Specialists | % ER Time | Research Notes |
Your table may have other variables, such as: geographic location, # cases, equipment, license requirements, rounds, or % primary care time. Some of this information you can get from the position description, some will come from your research on the position. At the end, organize the programs according to the most important variables for you.
My general advice is to rank every institution where you think you could be happy. The cost is not very significant, it minimizes the risk of not matching and having to do The Scramble, and is fairly efficient. Rank them in order of where you want to go. That’s it! Tell me what you think and how it goes!