This is the moment your whole medical school career has been hinging upon: 

Match Rank List Time!

It is time to get serious and come up with a rank list that maximizes your chances of getting your first choice residency. Ranking programs is a personal decision making process, because everyone has different priorities and life circumstances. Therefore, no one piece of advice applies to everyone. This is a run down of my own personal thoughts of what is important.


  • Urban vs. Rural
  • Small vs. Large
  • New city vs. Same city
  • Location, Location, Location!

Some medical students are married, some with kids, some with significant others who want to move, some with significant others who would rather die than move, and others simply want to explore the world! The physical location of your program can be important. It is critical to get buy-in from those who you cherish in your life because they will be equally effected by your match city as you are. Residency is also very tough. Sometimes it’s nice to be near your mother for a warm meal.

“Feel” of the Program

I heard the same great advice over and over while interviewing to write down the pros and cons of each program immediately after interviewing at that place… I never did. So I never had what could have been a handy list to help make my rank list. Instead, I relied on what my gut told me.

  • Did the faculty seem to enjoy themselves? 
  • Did they seem interested in me as a person as opposed to my board score? 
  • Did the residents seem engaged? 

Although not scientific, I don’t think you can discount what your gut tells you.


EM is unique among other residencies because of the mix of 3- and 4-year programs. There are many opinions regarding which one is better compared to the other. Regardless, I feel that this also becomes a personal question. Not everyone can afford or wants to wait 4 years until they are making an attending salary. I personally chose a 4-year program, because I felt it gave more opportunities in academics. But, it certainly has made it tough financially for an additional year.

Program Type

Community vs. Academic vs. County

All of these program types have their pros and cons. Lucky for us, we have a choice to select a program type that can suit our personal career goals and academic interests. Choose the one that is right for you.

Faculty / Mentors

It is helpful to have an idea of what the faculty have pursued during their careers. This gives an idea of what is available for residents. For example, if you hope to become a publishing monster, then you should seek out a program with a strong research department. Otherwise, it can be difficult to forge your own path. I was fortunate early in my residency to work with a mentor who gave me research and travel opportunities in disaster emergency medicine.

Other important things for consideration

  • Graduating resident careers (fellowships, job placements)
  • Emphasis on wellness
  • EM Board first pass rate
  • Accreditation status

Final tip: 

Don’t rank a program if you are absolutely against going there. Sometimes it is better to have to scramble than be miserable!

Please let me know what other tips you would add!


Source: Image 1

Nikita Joshi, MD

Nikita Joshi, MD

ALiEM Chief People Officer and Associate Editor
Clinical Instructor
Department of Emergency Medicine
Stanford University
Nikita Joshi, MD


Emergency Medicine Doctor Associate Editor of ALiEM Gun Sense Advocate #FOAMed #Docs4GunSense #MomsDemandAction Tweets represent my own views and opinions