Tales From The Trail: Finalizing Your Residency Rank List

Updated: Apr 7, 2019


Amidst the hustle of residency interview season, it’s hard to believe that in just a few short months you will be starting the next chapter of your medical training. This is likely to be in a new city, at a new hospital, and with new people. This provides you with the opportunity to grow professionally but also personally. However, 15 interviews later, how are you ever going to finalize your rank list? This can be a very difficult task for some students. Here is a quick collection of tips and tricks before you push “submit”.


Intra-interview Season Prep

Interview season can be a very hectic time as you balance your medical student duties, which may or may not include a clinical rotation, in addition to the logistical nightmare of scheduling flights and booking hotels as you hopscotch across the county for your interviews. However, taking a few minutes after each interview to reflect on your experience can simplify making your final rank-list. A few tactics to help with this include:

  • Important characteristics: Start by picking the top 3 most important aspects of residency. These should be personal to you and things that you value. Write one sentence about each, or rank each characteristic on a scale of 1 to 10. Some examples are below.

  • Location: Is the program urban vs suburban vs rural? What’s the distance between the different hospitals or clinical rotation sites, or more importantly what is the expected transit time?

  • Research: Are there resources to help you with design, execution, and data analysis? If this is important to you, determine if it’s feasible to complete research and what resources are available to you to do so.

  • Clinical experience: What is the rotation schedule and/or call schedule like? How many hours do the residents work – i.e. are they run ragged?

  • People: Don't underestimate the importance of liking the people you will see more than your friends and significant other. More on this to follow!

  • Headliner: Take a few quick notes after the interview while you’re flying home. One headliner or even just a sentence or two to sum up the program and how you feel about it can be very helpful later. “Perfect balance of education and clinical duties with doable call schedule”, “Great surgical experience, but residents seem really overworked and tired.”, or “Ideal rotation schedule between inpatient wards and outpatient clinic, and a great family friendly city”. Send thank you notes: A handwritten thank you note goes a long way. If you made a special connection with an interviewer, write a few sentences and incorporate a memorable topic you discussed together.


The Most Important Factor: The People

Try not to underplay the amount of time you’re going to spend working during residency. The educational staff with whom you work with will indefinitely shape you into the doctor you’re likely to be for the rest of your life. The staff matter, don’t get me wrong, since they are who you primarily learn clinical decision making and/or operative skills from. However, what really matters the most are the residents on your team. You will spend more time with your fellow residents than you will with your family, your spouse, or even your dog during residency training. Finding a resident group with good camaraderie is important. If you dislike the residents, you’re likely to enjoy residency less than you would have otherwise. What really makes a place unique is the people. A few pointers on spotting this out:

  • Meet them: Did you get to hang out with any of the residents? Did any of them come to the interview social event? If you didn’t meet them and none showed up, that can be a big red flag.

  • Saturday night test: Could you see yourself going out to do something on a Saturday night with these people? If not, then they probably aren’t the people you want to spend the next three to seven years with.

  • Never too good: Find a group where no matter their PGY, they are willing to pitch in to get the work done. No task is too small or mundane for the upperclassmen.


Your Gut Feeling > Playing the Algorithm

Your final rank list should be a list of all the programs you’re willing to attend truly ranked in the order by which you’d like to attend. Don’t forget that the residency matching algorithm favors the student over the residency program in all cases. So there’s no benefit to you by ranking programs in the order which you think you’ll be more likely to match rather than the order in which you’d like to attend them.


Although residency interviews and finalizing your match list can be somewhat stressful, it’s an exciting ride. You’ll see some awesome cities, meet interesting people, and try some new foods. But, take time to reflect. Take time to embrace the upcoming change. Take a moment to realize how this experience and where you ultimately match is one of the most important decisions of your professional career. And most importantly, take the time needed to ensure you make an informed decision about your final residency match rank list.



The author Bristol Whiles, MD is a PGY2 resident in Urology at the University of Kansas. Dr. Whiles is a tutor and residency application advisor for USMLE Pro.

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