How to Create Your Residency Rank List

First you will need to use software programs such as FREIDA^TM or Residency Explorer^TM, which medical schools often provide access to, in order to not only locate programs but decide which you may be a good fit for. As such, we will go through a few cornerstones of finding the ideal program for you based on a number of variables. 

Residency Program Location 

Occasionally medical students will pinpoint areas of the country they desire (or do not desire) to live which can serve as a starting point for your residency program list. For instance, if you have family in the Northeast and would like to filter your search of programs preliminarily to that area of the country, this can be a good way to get programs on your list. When interviews come around, this might also serve as a tie to the area and increase your chances of being ranked high as well. Similarly, you may also decide that certain areas of the country are just not for you, which is also okay, and can be used as a mechanism to leave programs in that area off of your list. 

Residency Program Type: Community, University, or Community-Based University-Affiliated 

At this point you may have seen various different programs, each of which likely fall into one of these categories, but how to choose which is best for you? Here is a few considerations:

• Are you wanting to do a fellowship? 

• • Often, university or community-based university-affiliated often have established fellowship program tracks at the institution. These are often the very programs that take their residents into fellowship, so it can be beneficial to pursue these programs in anticipation of having exposure to both an academic setting and fellows in the specialty of interest while in training. 

• What are your interests or passions in medicine?

  • If you are interested in medical education, perhaps a university-based environment might be best to allow you to train in an environment that you will eventually work in. Furthermore, other considerations of programs are whether they have tracks for primary care, global health, advocacy, or narrative medicine, if this is something of interest. A program that has offerings that align or parallel your own might be a reason to choose one program on your list over another since these are likely the aspects that drove you to medicine in the first place. 

• Are you interested in research?

  • While community based programs can also have research endeavors, many university or university-affiliated programs will have physician scientists of whom associate themselves with the institution. To that end, this will allow many diverse opportunities in various fields to pursue scholarship prior to fellowship training.

• Do you desire more hands-on experiences or procedure/POCUS training?

  • The opportunities for hands-on procedures can often come along with community-based training where there are no fellows who are traditionally performing these procedures regularly. That being said, many university-based or community-based university-affiliated programs also have distinguished tracks for ultrasound or procedure training which can be a consideration when creating your list. 

In short, tailoring your residency rank list to your ideal program in terms of offerings, interests, or scholarship endeavors can also align with community, university, or community-based university-affiliated programs and allow for the unique opportunity to uncover many desired programs. 

Residency Program Size 

Many times, as trainees, we have an affinity towards different sized groups whether that be larger communities that then break up into smaller groups or just a small group to begin with. Whether community or university-based, programs have a varying size of residents in each class, so deciding which type of group you might fit in best can be beneficial. If you are flexible or do not have a preference, you might add multiple programs of varying sizes and later get a feel for their sense of community when interviewing.

Benefits

If a priority, applicants might also decide to include programs with a certain threshold of salary, free parking, meals offered by the hospital/program, or four vacation weeks. Including these things may sometimes come as an afterthought to some, but may be the same things of which are of the utmost importance to others. 

Other Considerations: IMGs and Osteopathic Students

First, if you are an international graduate and are requiring your prospective program to sponsor a visa, it will be important to understand which programs (based on your selections above) sponsor either H-1b or J-1 visas. Before submitting your ERAS application, you will want to ensure all of your programs also check this box in order to optimize your chances of being interviewed and later being ranked highly. Also, it is beneficial to use programs such as FREIDA^TM or Residency Explorer^TM to locate the percentage of international medical graduates matched into each program. To that end, a higher percentage can mean they historically take international medical graduates and can help to optimize your chances of matching as well.

Furthermore, osteopathic students will want to ensure COMLEX is accepted by programs on their list if this is the only board exam they have taken. Alternatively, many osteopathics do, in fact, take USMLE step exams, though you may also want to see what the percentage of osteopathic students have matched into the programs on your list in the past. Low percentage does not necessarily equate to zero, though you will want to be meticulous to apply to programs with a considerable number of osteopaths and perhaps programs with osteopathic recognition if this is a point of interest in your training. 

As you can see, there are many ways to create a residency rank list, though the bottom-line is that it is personalized to you and your interests in hopes of pursuing a postgraduate training which adheres to you as an individual. If you need a little help in getting started with a residency list see the example here for further guidance and good luck!