Tips to Create a Rank Order List
Written by Morgan Pratt, MD
As interview season ramps up you may be starting to organize your notes, or like me, edit that Excel spreadsheet. It's the one you might have been working on all cycle in hopes to gain clarity to the question coming from every loved one, advisor, and friend: What’s your first choice?
When I was building my spreadsheet I picked all sorts of criteria that I felt were important; curriculum, location, call schedule, vacation time, EMR, perks, etc… I ranked each program within these categories and hoped it would lead me to an unwavering first choice and rank list.
However, it did not. The list was scattered and there was no resounding first choice based on the criteria I had thought were so important. That is not to say that these topics are not worthwhile to ask about as they can greatly impact your wellness and the overall tone of the program, but be wary of putting too much importance on these aspects alone without taking into consideration the whole picture.
I realized that no program is perfect, but there can be a program that is the best fit for you. This is the program that you will be the happiest and most motivated version of yourself in. You will get good training no matter where you go, that’s what the ACGME is for. What you need to focus on is where you will feel at home and supported.
In medical school, we are told to find "your patients and find your people". Residency application is the latter half of this equation. Finding your people is not a math equation or a formula plugged into an excel spreadsheet. It’s a feeling and that can’t be quantified.
Here are some questions that I found helpful in the search to find my people when reflecting upon my interviews:
What activities do residents do outside of work? How often are there resident gatherings?
How would you describe the tone while at work?
How do faculty and residents get along?
What do residents and the program do to avoid burnout?
What are some examples of how the program administration has made changes or responded to resident feedback?
Describe the atmosphere of learning.
How do residents support residents through mentorship?
So my advice is to let go of whatever reputation or Doximity rating that is swaying you and listen to your gut. These are the people you will be spending the next 3-6 years with, working 12-24 hour shifts alongside, and seeing more of than your family at times. Surrounding yourself with people you enjoy working with will make the whole process much more enjoyable.
Remember whether you match at your first choice or last choice, you have agency to make the experience of residency what you want it to be. Programs are constantly growing and changing, so bring something new to your program that it’s missing, or change the culture for the better with your energy and passion!
