How to choose your rank order list for the NRMP

When trying to decide how to rank the programs where you interviewed, go with your gut. Your gut response to situations is a real physiological response which protects you. Listen to yourself. You know what is right for you better than anyone else. Additionally, instead of asking every medical student you know, how he/she would rank the programs where you interviewed, ask them what experiences he/she had at the programs. It would even be better to call one of the residents at your top program and ask them about additional questions that you have. Get to know the people you may be working with. Develop a deeper connection. If you do this, you will be more comfortable with your ranking decision. You have time to decide on your ranking so there is no rush to enter it, but do not wait until the very last day in case there is a bottleneck or something happens with the computer system. Good luck.

Competitiveness will skyrocket

The 2020 Match will be the biggest match ever, since the NMS and NRMP unified. The only way that there is another large growth in programs and residency positions in the NRMP is if congress allocates additional funding streams for residency programs. With the federal government’s history on funding, this seems like an unlikely event in the near future. 

This year will also have a record breaking number of participants in the NRMP because of the inclusion of the osteopathic students. What students need to prepare for, is that the number of students participating in the NRMP will continue to grow each year, regardless of the lack of parallel growth in residency programs and positions. This is occurring because of the opening of new medical schools and growth of existing school class sizes. 

What does this mean for medical students? Every year, the number of unmatched students will increase. Competitiveness will skyrocket. Programs will become overwhelmed. Students will become more desperate to match. All organizations must come together along with students, physicians, and residents to have a conversation. More alternative residency programs must be considered. All ideas must be on the table. The AAMC, NRMP and AACOM must not wait to move on this. More money needs to be allocated to this. More lobbying for additional funding.

Does the NRMP have some responsibility for allowing more applicants to register than positions are available? Should there be a refund for students who did not get a residency position because of lack of residency positions? We must put these medical students first. Most have several hundred thousand dollars in debt. It is our duty to solve this problem. Let’s work on this.

Both 3rd and 4th year students should be updating their C.V.’s.

If you are a 3rd year student, you should have an updated C.V. that you give to your preceptors when you do rotations. If you decide to ask a preceptors for a LOR then give him or her another copy along with the ERAS letter request form.

C.V. formatting should be a clean simple layout which is easy to read. 11pt, 1 inch margins, modern font. Do not run bullets all the way down the page, or use lines to separate each section, or put your photo on the page. C.V.’s run 2 to 4 pages at the most.

Put both your matriculation date and your graduation date at the top of the page with the full name of your degree. If your GPA is in the top 1/3 then include it. If your board scores are above the mean for your specialty choice then add those too.

Add a section for leadership near the top. This is a very important skill that is hard to teach. It is good to demonstrate previous experience.

A research section should be next. If you have a lot of publications and presentations then choose the best 5 or so. If you don’t have any in medical school then use undergraduate research.

Frame your work experiences in terms of medical experiences or leadership. Same with volunteer experiences. Tell the program director how you will use your experiences to benefit his or her program.

Add a brief section with your personal interests in order to show balance in your life.

4th year students waiting for the upcoming match need to update their C.V. in case they do not match. Add any completed research publications or presentations that were not in the original ERAS application. Add board scores which were not originally on the transcripts sent to programs. If possible get an addendum of comments from 4th year rotations which were not included in the MSPE sent on October 1st. Get back-up LOR’s for a back-up specialty now instead of trying to do it during match week in case you don’t match. For students with 5 or less interviews, continue to network with your connections to see if you have missed anyone who could help you.

Ask faculty or other medical students to review your C.V. for typos, errors and clarity.

You can also hire a professional to review your C.V. and give you feedback. This is a service that Brenda Chezek Consulting provides for a minimal fee. If interested, you can send a message on LinkedIn or to brendachezek@yahoo.com.

Schedule time off for Match week now

Match day is not the time to try and take off a rotation, if you don’t match. If you have 6 or less interviews then you need to talk to your clerkship coordinator, your clinical dean, preceptor or boss and ask for time off as needed. If you match then you can return to your rotation or work.

Planning is key to managing the stress and anxiety related to the Match. Each student receives an email in the morning on Match day telling him or her if he or she matched or not. The news of not matching can be a shock causing feelings of anxiety, despair, rejection, depression and disbelief. Many type A personalities are not familiar with these feelings, which compounds negative emotions. Students will need some time to process feelings.

Family and friends are not usually familiar with the Match process so it can be isolating to have these feelings and not have people really understand the level of distress it can cause.

If a student is lucky enough to have a trusted friend also going through the Match, it can still be embarrassing to discuss not matching. If the friend matched and you did not, then they still don’t understand what you are going through to the full extent.

With all these feelings and emotions occurring during a short period of time, applicants need to do as much as they can in advance to focus and start thinking about next steps.

For students who received three or less interviews, consider taking the entire week off if possible to focus and give yourself the best chance of matching during SOAP.

What to do while waiting for NRMP Rank Order List deadline

With two months before the Rank Order List (ROL) deadline for the National Residency Matching Program (NRMP), there is still time to make connections and demonstrate your skills and abilities to program directors. This is a time for integrity and sincerity. Remember that after the match, you will be working with these professionals indirectly for much of your career. You will see them at conferences and work with them in your community. Your actions during the match may follow you, if foolish.

According to the NRMP applicant policy FAQ’s: You may volunteer information about where you have applied and how you plan to rank programs, to programs. For students who have had more than 10 interview offers. Even if you already sent a thank you note. You should send your top three program directors thank you notes again and let them know that you will be ranking them highly in the match. For your top program, you might also want to reach out to residents who you connected with and let them know your rank choice. Be careful about this. You don’t want one of your top programs to find out and rank you lower because of this. Be especially careful if ranking multiple programs at one facility because the program directors may talk to each other about applicants.

For students with 6 or less interviews, I would recommend sending thank you letters to all the places you interviewed and letting them know that you will be ranking them. Be specific in what you like about the programs when writing to them.

Students with 5 of less interview offers need to continue to try and rotate, or visit or even interview at locations. You need to get to know the program directors. They need to see your work ethic. They need to see that you do not bring drama to the environment and that you are there to learn and be a productive member of the team. The relationships that you make and build do not end on Match day. You need to continue to show people who you are as a person and a future physician.

For students who have gone through the match multiple times, you must email people who you have worked with or who have interviewed you and ask them for full and honest feedback about your strengths and weaknesses. If you are not a native English speaker, and your English may need improvement, consider taking advanced lessons to improved communication skills. Contact your former classmates and find out how they matched. Don’t stop working towards your goals.

Who I am.

After working for medical schools for over 12 years, and reviewing data for over 1,000 medical students, I started Brenda Chezek Consulting, LLC to advise students on the residency process and guide students through the steps to Match. I am passionate about helping people and believe in honesty and integrity.

I have read over 1,000 personal statements, analyzed student match probabilty based on multiple key data points, and read several thousand letters of recommendation for students. The residency match process is complicated and leaves many students with multiple questions. Subscribe to my blog for timely updates on what you should be doing and at what times in preparation for the Match.