A mysterious algorithm is fed thousands of rank lists from programs and applicants alike, ideally resulting in one match per applicant. The Match is as exciting as it is nerve-wracking, representing the culmination of years of hard work and preparation. It can also feel daunting, as though your future is in the hands of a computer system. While this isn’t entirely untrue, you have more control than you may think.
This is because your rank list matters. In fact, as discussed in this NRMP video, your preferences are weighted more heavily than those of programs. Creating a thoughtful rank list is the most important step you can take to improve your chances of a successful Match. This article is here to guide you through your Residency Match tips, helping you prioritize what matters most to you in a program.
Location is one of the most important factors to consider when ranking programs because it affects nearly every aspect of your life. Ask yourself:
Where do your close family or friends live?
Having a support system during residency can be invaluable. While you will form strong friendships during your training, an existing support system can ease the transition. Even if you do not visit home often, living far away may mean using your limited vacation time just to see loved ones, which could otherwise be used for rest or travel.
What cost of living is reasonable to you?
Medical trainees are often underpaid relative to the hours they work. Some high-cost cities offer housing stipends or have unionized programs, but everyday expenses can still leave little for savings or leisure. On the other hand, smaller cities or towns typically offer a lower cost of living, shorter commutes, and potentially the ability to afford a home or take memorable vacations. A more affordable location can help you financially thrive early in your career.
Would you be happy living only in a big city or only in a small town?
Someone raised in a city may struggle with rural life and vice versa. Stay open-minded but be honest with yourself about what environment suits you best.
Pro tip: If you love a program but are unsure about its location, consider visiting the area before ruling it out. You may be surprised by its charm or sense of community.
What patient population do you want to work with?
Different regions serve different populations. Large cities often provide exposure to diverse demographics and pathologies, while rural areas may offer unique learning opportunities in community-specific conditions or trauma cases. Consider how these factors align with your goals and values.
Where does your partner want to live?
If you have a significant other, factor in their preferences. They may have more time to enjoy the community, and proximity to their support network can make your shared experience more positive.
While all residency programs must meet ACGME requirements, each offers different opportunities beyond the basics. Reflect on the following:
Is residency the final step in your training?
If so, your goal is to be fully prepared to practice independently. Choose a program with strong clinical exposure and comprehensive education. Speak with current residents to assess how confident they feel managing patients on their own.
If you’re considering fellowship, programs with strong academic, research, or educational support may better prepare you for competitive applications.
What tangible skills are important for you to gain?
Do you want experience in certain procedures, surgical techniques, or academic research? Do you want to become skilled in POCUS or grant writing? Think about your future goals and choose programs that can help you build those specific skills.
Pro tip: Consider the institution as a whole. For example, if you want to become a trauma surgeon, look for programs with Level I trauma centers. For neurology, comprehensive stroke centers may offer better exposure to relevant pathology.
“We wish you could join us in person” is something you’ll hear often on the interview trail because it’s tough to gauge a program’s culture through Zoom. To assess a program’s environment, consider:
Did you speak with residents without faculty present?
Did residents seem happy, engaged, and supportive of one another?
Did any comments from faculty or leadership make you feel uncomfortable or disrespected?
What do others say about the program?
Is the program on probation?
Does the program value education, or are residents primarily doing service work?
For surgical programs, when do residents start operating?
Pro tip: One of the best ways to get honest insights is by talking to residents outside of the official interview process. Reach out to your medical school’s alumni coordinator to connect with former students at programs you’re considering.
Programs that boast high board pass rates or strong fellowship placement can be a reflection of solid training and educational support. Some programs will present this data during interviews, but others may require you to ask directly.
Although it’s not the most important factor, the name of the residency can carry weight, especially when applying for fellowships. Prestigious programs may have more funding, research opportunities, and faculty with strong academic influence. A “top name” is not required for success, but it may provide certain advantages depending on your long-term goals.
Do not overuse anonymous websites like Reddit or Student Doctor Network. While these forums can offer anecdotal insights, they are prone to misinformation or overly negative posts.
Do not obsess over rankings such as those from US News or Doximity. Small differences in ranking (for example, #29 vs. #35) are unlikely to reflect meaningful differences in training quality.
Do not wait until the last minute to certify your list. The NRMP system can slow down or crash due to last-minute traffic. Submit early to avoid unnecessary stress.
Creating your rank list is a deeply personal and strategic process. Focus on your own priorities, goals, and needs to build a list that sets you up for a fulfilling training experience and career. You have more control than you think—and with the right planning, the Match can become a powerful step forward on your journey to becoming a physician.
