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### Enhancing Medical School Experience: Insights on Match Rank-Order Lists

For many medical students, developing a Match rank-order list involves balancing various priorities and navigating through a plethora of advice—both solicited and unsolicited—from faculty members, peers, and resident physicians. This was particularly true for Haidn Foster, MD, as he deliberated on his choices for the Match during his final year at the University of Cincinnati College of Medicine in 2022. Ultimately, Dr. Foster emphasized the deeply personal nature of constructing a rank-order list.

According to Dr. Foster, the process is highly individualized, tailored to what holds the most significance for each applicant. He highlighted that even individuals who interviewed at the same programs but had slightly different residency priorities might formulate entirely distinct rank-order lists and still achieve a similar level of satisfaction with their Match outcomes.

As the deadline approached for residency applicants to finalize their rank-order lists, Dr. Foster shared valuable insights based on his own experience and hindsight reflections. One key aspect he underscored was the importance of considering long-term plans when selecting a residency program. Dr. Foster, now a second-year internal medicine resident at Penn State Health with aspirations for a hematology-oncology subspecialty, emphasized the value of choosing a program that aligns with future fellowship goals. Additionally, he highlighted the benefits of matching at a program offering the desired fellowship in-house, enabling residents to gain a comprehensive understanding of their chosen field.

In the process of ranking programs, Dr. Foster acknowledged the need to make compromises, especially when torn between academic and community programs. Despite emotional connections to certain community programs that resonated with his values, he recognized the necessity of prioritizing academic programs to support his fellowship aspirations.

Dr. Foster also emphasized the significance of identifying personal deal-breakers when evaluating residency programs. For him, geographical location was not a decisive factor, as he had a flexible attitude towards relocation—a mindset cultivated through previous transitions during his medical training.

Reflecting on his virtual residency interviews amidst the COVID-19 pandemic, Dr. Foster highlighted the challenge of recalling specific details about each program towards the end of the interview season. He emphasized the value of maintaining detailed notes and leveraging one-on-one conversations with current residents to gain deeper insights into program attributes.

Moreover, Dr. Foster advised against becoming overly fixated on minor details, such as the specifics of the intern year schedule, which may not significantly impact the overall residency experience. He encouraged applicants to dream big and prioritize their genuine preferences when constructing their rank-order lists, emphasizing that ranking one’s top-choice program first carries no negative consequences.

Finally, Dr. Foster recommended finalizing the rank-order list decisively and avoiding last-minute changes post-certification to minimize unnecessary stress. By offering these insights, Dr. Foster aimed to guide medical students, international medical graduates, and other applicants through the residency application process, from interview preparation to rank-order list compilation, ultimately facilitating a successful Match outcome.