Three Rank Order List mistakes to avoid (and tips to get it right)

unconventional interview preparation for IMGs

The deadline to submit your rank order list is 9 pm EST Feb 22, 2017. 

I was on call for 10 straight days which is brutal.

But, I have been getting 1-2 emails a day from IMGs asking for ROL help. Great, I love that. Asking for help from people who have done it before you is the smartest and easiest thing in the world. I have been pretty consistent getting back at most of you with my recommendations on ROL.  I know there is a ton of information on the internet including NRMP(R) website ( But I still see some common mistakes that IMGs make.

I will first talk about the three most common mistakes IMG make in creating their ROL. Then, I will give you a tips to create a ROL in such a way that helps you achieve your career goals after residency and finally there is a download link to get the algorithm I personally used to make my rank order list (It is very helpful if you want to do fellowship, if you definitely don’t want to do fellowship and also if you are ‘maybe; maybe-not’ about fellowship).

Common ROL mistakes IMG make: 

1 .Ranking the programs based on the likelihood of them ranking you.

I have heard this a million times before.

Yet, when I was constantly thinking about it when I was ranking programs during my match.

The truth is, the ranking software has your best interest in mind. It is designed to ensure you get matched to the program you listed higher than the one you listed lower.

Irrespective of where the program ranked you.

Eg. If program A is the best program for you and you ranked them first. But they have ranked you tenth. You still have a chance of matching there if the nine other people before you have found a ‘final’ match position at this or some other program and program A still has a spot.

On the flip side, you ranked program B at the last spot. But you know that program has ranked you high because you got good vibes from them at the interview or in your post-interview thank you notes.

Eg. If program B is your least favorite program. But they loved you. They have ranked you 1st and you ranked them 5th (the last spot on your ROL). All the people that have ranked the program high will get a ‘tentative’ match position in the program until their spots are filled. If by this time, you did not get a ‘final’ position in one of the preferred programs (1 to 4) on your list, the ‘tentative’ position given to the other candidate will be discarded and you will get a ‘final’ match position at program B because they ranked you high.


 2. University or university affiliated programs are always better than community programs.

Yes, it looks good on your CV. Yes, you can boast about it to your friends back home that you trained at the University of ABC. But, this may not help you in the long run if the university program does not offer what you want to do after residency or none of their previous residents went on to do this thing you want to do. I have seen a lot of real life examples where candidates got much better jobs, fellowships, research training because they trained at a program which was focused towards their career goals. I have explained this further in the algorithm.

3. Changing the rank order list at the very last moment.

You may have your ROL ready already. Or, you are still working on it. Give yourself 2-3 hours. Preferably in the morning after you had your tea/coffee and breakfast. Think about what is the one thing you are seriously considering for your career. Is it being a cardiologist or an academic hospitalist or a primary care doctor back in your home country?  Remember, this can and most likely will change as you go through your residency. But that’s okay. For now, you have something in your mind. Plan for that. Go through the algorithm from below or something of your own. Make a rank order list. Avoid the mistakes above. Ask your mentor, close friend, previous residents or me if you like. After that, stop. Don’t browse forums or facebook to find faults with your ROL. People post their ROL on forum based on their goals and thought process. Not yours. Frequently changing the list after hearing others opinion will ultimately make you unhappy about your choices.


Tips to building a solid rank order list


1. Fellowship interest: If you want to do fellowship, pick the program where your chances to match at your desired fellowship program after residency are the highest. Two most important things to consider when deciding which residency programs will be best for you to get fellowships in future are:

a. In-house fellowship- Programs with the highest number of in-house fellowship of your choice spots

b. Programs who have the highest number of previous residents go into your fellowship of your choice.

2. Visa Requirement: Once the fellowship part is taken care of or if you are not interested in fellowship at all, consider visa options. I prefer H1b programs before J1. There is a lot of debate about H1 vs J1.  But after seeing a lot of candidates and my own friends go through their training and in their medicine career now, I feel H1 is a safer bet.

3. Interview experience: Once fellowship and visa issue is analyzed, pay attention to how you felt during your interview there. You have a gut feeling about each program. Ask yourself if you could stay in the place for three or more years?

Get the perfect rank order list for your career goals
This FREE TOOL will show you:
  • A step by step algorithm that guides you to rank the programs you interviewed at.
  • Shows how university programs are not always the best option for you.
  • How to optimize your rank order list for fellowship chances in the future.
  • Avoid common ROL mistakes that many IMGs make.

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