Creating Rank Order Lists for the 2018 Residency Match: What Foreign Medical Graduates Need to Know


In an earlier post, we discussed the timeline for the 2018 Residency Match. Even though you have made it through some of the toughest parts of the process — preparing your personal statement and CV, submitting letters of recommendation, and surviving the interviews — there is still work left to do. When the Rank Order List Entry opens (January 15, 2018 — mark your calendar!), you have a little more than a month to create your list and get it certified electronically in then NRMP Registration, Ranking, and Results (R3) System. In order to participate in the 2018 Match, your rank order list must be complete and certified by 9:00 pm Eastern Standard Time on February 21, 2018. Read on to find out what foreign medical graduates need to know about creating and certifying an Rank Order List (ROL).

The Basics of the Rank Order List (ROL)

The Rank Order List (ROL) is the place where you, as an aspiring medical residents, have the chance to provide the NRMP with a list of programs in which you are interested, ranked in order of preference. After residency interviews are complete, candidates and program directors both create ROLs, and the information on the ROLs is used to determine the outcome of the Match.

There are two types of ROLs: primary ROLs and supplementary ROLs. On the primary ROL, you can list categorical, preliminary and/or advanced programs. If you rank an advanced (PGY-2 level) program on your primary ROL, you can also submit supplemental ROLS of preliminary programs that are linked to that advanced program.

Considerations When Creating Your Primary ROL

The NRMP allows candidates to list 20 different programs on the primary ROL and 20 different programs on each supplemental ROL. After that, you have to pay a fee. However, it is important to note that most foreign medical graduates interview with far fewer schools, so you probably do not have to worry about exceeding the limit.

That being said, foreign medical graduates who have ranked a larger number of programs within their preferred specialty have a higher likelihood of getting matched. According to data from the 2016 residency match, the average number of contiguous ranks for matched candidates was 6.3, as compared to 2.5 for those who were not matched.

When creating your primary ROL, you should also consider the competitiveness of the programs to which you are applying. The NRMP recommends that foreign medical graduates apply to a range of programs that vary in their levels of competitiveness.

Another opportunity you may want to consider is ranking programs as a couple with another applicant. If your partner or close friend is also applying to residency programs in the United States, you can link your ROL with that person in order to increase the odds that you will be matched to programs that are in the same geographic area. Whether your partner is another foreign medical graduate or a graduate of a US medical school, ranking programs as a couple can be a great way to ensure that your Match outcome fits with both your career goals and your personal priorities.

Beyond the Primary ROL: Creating a Supplemental ROL

If you included an advanced (PGY-2 level) program on your primary ROL, you need to include a supplemental ROL with a list of preliminary (PGY-1 level) programs. Getting matched in this way would mean simultaneously securing both a preliminary and an advanced position at the same time. This can relieve stress for foreign medical graduates because it guarantees that you will have the opportunity to complete a “full course of training.”

In most cases, the preliminary programs on your supplemental ROL are tied to the geographical location of the advanced program, so your supplemental ROL may look significantly different from your primary ROL. However, you should note that the matching algorithm will only consider your supplemental ROL if you get matched to the advanced program on your primary ROL. If not, the information on your supplemental ROL will not be considered in the matching process.

Finalizing Your ROL(s): The Certification Step

Once you have finished an ROL (either a primary ROL or a supplemental ROL), it must be certified. That means you have to click the “Certify List” button in the R3 system, at which point you will be prompted to enter your username and password. This confirmation should not be taken lightly — when you certify an ROL, you make a binding commitment to enter any program at which you match.

Nevertheless, it is still possible to change an ROL after it has been certified — as long as the February 21 deadline has not yet passed. When you have made a change, you must re-certify the new ROL so that it can be properly processed by the Match algorithm.


Getting matched to a US medical residency program is a long and challenging process, but FMG Portal is here for you every step of the way. Contact us today to learn more about everything we offer!

Important Dates for the 2018 Residency Match


For foreign medical graduates who are looking to be matched to a US medical residency program in 2018, the winter months of waiting for Match Day can feel just as hard as the application process — but you need to remember that there are still a few key deadlines you need to meet. If you are participating in the National Residency Matching Program (NRMP) Main Residency Match in 2018, there are several important dates that you should keep in mind as you look ahead to the new year.

January 15, 2018 — Rank Order List Entry Opens

In less than a month from now, the rank order list entry opens at 12:00 pm Eastern Standard Time. Even though there is another month after that before the rank order list entry closes, it is important to start thinking about your rank order list in advance. That way, you will be able to dedicate enough time to the development of a strong rank order list, and you won’t end up feeling rushed as the deadline approaches.

When you participate in the Main Residency Match, you will submit a primary rank order list that may include a combination of categorical, preliminary, and advanced programs. Depending on your interests and career goals, you may also decide to submit a supplemental rank order list of preliminary programs that are linked to more advanced programs, which would enable you to lock down a PGY-1 and a PGY-2 position at the same time. It is important to take the time to explore these options before and during the period in which the rank order list entry is open.

As we discussed in an earlier post, the number of programs on your rank order list may also matter if you are a foreign medical graduate. According to data collected by the NRMP after the 2015 Main Residency  Match, foreign medical graduates who ranked a larger number of programs within their preferred specialty area were more likely to be matched within that specialty area. Specifically, the average number of contiguous ranks for those who were matched was 6.3, as compared to only 2.5 for those who were not matched.

The NRMP also advises foreign medical graduates to include a combination of more-competitive and less-competitive programs on their rank order lists. Right now is a great time for you to start exploring the options and considering the competitiveness of your programs of interest, while also accounting for personal considerations, like institution locations. That way, by the time January 15 rolls around and the rank order list entry opens, you will already have a solid list of programs in hand.

February 21, 2018 – Three Major Deadlines

Five weeks after the rank order list entry opens on January 15, you need to have your list finalized. At 9:00 pm Eastern Standard Time on February 21, 2018, all rank order lists must be certified. Make sure yours is in by the deadline!

That same date — February 21, 2018 — is also the late registration for the 2018 Main Residency Match. The regular registration deadline was November 30, 2017, but if you missed it, you still have the opportunity to participate. Unfortunately, you have to a late fee of 50 dollars alongside the regular registration fee, but that is a relatively small price to pay if you are truly committed to pursuing a US medical residency in 2018.

This deadline also applies to Match withdrawals. If you elected to participate in the 2018 Main Residency Match but want to withdraw your application for any reason, you have to do so by February 21, 2018. Withdrawing your application from the Main Residency Match is a serious decision, considering all of the hard work you have already put into the residency application process, so you need to make sure you give yourself enough time to fully consider your options before the withdrawal deadline arrives.

Match Week: March 12 – March 16, 2018

Match Week starts on Monday, March 12, with the start of the Supplemental Offer and Acceptance (SOAP) program. At 11:00 am Eastern Daylight Time, you will find out whether you got matched. If not, you can participate in the SOAP until it concludes on Thursday, March 15.

Friday, March 16, 2018, is the day you’ve been looking ahead to for months — Match Day! At 1:00 pm Eastern Daylight time, Match results are sent to applicants by email and posted in the R3 system. On that day, you will find out if you made it into the program of your dreams and are on your way to a US medical residency program in July 2018.
If you’re a foreign medical graduate looking to make that dream a reality, FMG Portal is here to help you at every step of the process. Contact us today for more information about what we offer!

More Lessons from the 2016 Residency Match Data: Are Outside Experiences Important?


Last week on the blog, we discussed the NRMP report on the outcomes of foreign medical graduates in the 2016 Main Residency Match. To create this report, the NRMP tracked the rates of match success for foreign medical graduates based on a number of key measures, such as program ranking choices and test scores. As we mentioned in last week’s post, there are clear lessons that you can learn from the data on ranking choices and test scores as a foreign medical graduate preparing for a U.S. medical residency.

However, when it comes to the report’s information on foreign medical graduates’ outside experiences, the implications of the raw data are less clear. Read on for more about how you can understand the numbers and apply the information to maximize your chances of match success as a foreign medical graduate.

Statistics on the Outside Experience of Matched and Unmatched Foreign Medical Graduates

As a foreign medical graduate, you might find yourself asking the question of whether or not it is important for you to get outside research and/or work experience before you apply for a U.S. medical residency program. At the outset, the data in the NRMP report doesn’t seem to provide much help in answering that question. For all the different types of outside experiences that the NRMP measured, the average numbers for matched and unmatched foreign medical graduates was almost exactly the same. Consider the following statistics:

  • For foreign medical graduates who were matched in 2016, the mean number of research experiences was 2.2. For those who were unmatched, the mean number of research experiences was also 2.2.
  • For unmatched foreign medical graduates, the mean number of abstracts, presentations, and publications  was 6.4 — slightly higher than the same statistic for matched candidates, which was 6.1.
  • The mean number of work experiences was 5.3 for matched foreign medical graduates and 5.5 for unmatched candidates.
  • For foreign medical graduates who were matched, the mean number of volunteer experiences was 3.5, as compared to 3.4 for candidates who were unmatched.

When you look deeper into the data and examine these same statistics broken down by specialty area, the numbers only get more confusing. For some specialty areas, the mean number of experiences reflects the overall average — about the same for matched and unmatched candidates. There are only a few where the average number for matched candidates significantly outweigh those for unmatched candidates. There are even some specialty areas where the average number of experiences is considerably higher for unmatched applicants.

What the Statistics Mean for You as a Future US Medical Residency Applicant

Considering these statistics can be daunting for foreign medical graduates. Based on the data, it just isn’t clear whether having more outside experiences — or any at all — can truly help you in the matching process.

One of the reasons why it is so hard to draw conclusions from the data is that averages are prone to skewing. Consider the data for abstracts, presentations, and publications. While the average for both matched and unmatched candidates was around 6, nearly 40 percent of the of the applicant pool of foreign medical graduates in 2016 had no publications at all. This indicates that certain applicants are skewing the data, so if you have less than 6 publications, it doesn’t mean you fall short of the “average” applicant.

Ultimately, the main takeaway from the NRMP data about outside experiences is that the number of outside experiences you have does not really matter. What matters is the quality of the outside experiences — and your ability to illustrate that quality on your application. An outside experience can be worthwhile if you can weave it into your personal statement — writing about how it has prepared you for your residency and how it has influenced your career goals — or if you can get a letter of recommendation from a supervisor or mentor who can speak to your excellent performance during the outside experience. Otherwise, if the outside experience is just a line item on your CV, it probably won’t make much of a difference for whether or not you end up getting matched.

Thus, one of the best options for an outside experience is a clinical externship in the United States. Completing a clinical externship in the United States is ideal because it shows residency programs that, as a foreign medical graduate, you are already comfortable working in a clinical setting in the United States. After completing a clinical externship, you may also be able to get a letter of recommendation from an attending physician in the United States, which is preferred (or even required) by many U.S. medical residency programs.


If you’re interested in completing a clinical externship before you apply for a U.S. medical residency program, FMG Portal offers 3-month and 6-month externship options in a wide range of specialty areas. Contact us today for more information!


Lessons for Foreign Medical Graduates from the 2016 Main Residency Match


During the 2016 residency matching process, the National Resident Matching Program (NRMP) monitored the outcomes for all graduates of foreign medical schools. Specifically, they kept track of match success, specialty preference, ranking information, and applicant characteristics. The data they collected provides valuable information for future applicants. If you are a foreign medical graduate looking to apply to a U.S. medical residency program in the future, there are several key lessons that you can take away from the NRMP report.

Program Ranking Choices: The More the Better

The NRMP report can be particularly helpful if you are a foreign medical graduate trying to figure out how to best to rank programs on your application. According to the NRMP, foreign medical graduates who were successful in matching to their preferred specialty were more likely to have ranked a larger number of programs within their preferred specialty. Specifically, the NRMP reports that, on average, foreign medical graduates who were matched had longer lists of contiguous ranks than those who were not — 6.3 continuous ranks for matched foreign medical graduates, as compared to only 2.5 for those who were not matched.

As a foreign medical graduate, you might be tempted to limit the number of programs you rank within your top-choice specialty area and add a greater number of programs in non-preferred specialty areas that you think will be easier to get into. While the NRMP does recommend applying to a mix of competitive and less-competitive programs, the data suggests that applying to more programs within your specialty area of interest could increase the odds that you will be matched at all. Instead of spending your time trying to locate the less-competitive programs, you should focus on polishing your application show that it demonstrates that you are truly passionate about the your top-choice specialty area.  

At the same time, if you do plan to apply to a particularly competitive specialty, it can be helpful to identify an alternative specialty and rank your preferred programs within that specialty area, according to the NRMP. Based on the data, whether or not you choose to do this will probably not have a significant effect on your odds of getting matched. The mean number of distinct specialties ranked by foreign medical graduates who got matched in 2016 was 1.3, whereas the mean was 1.4 for those who were not matched — practically no difference at all. So you shouldn’t be worried that identifying an alternative specialty will reduce your odds of getting matched.

The Importance of Test Scores

Another key takeaway from the NRMP report is that there are two tests that can make a significant difference in determining whether or not you get matched: the USMLE Step 1 and the USMLE Step 2 CK. For both of these exams, the average score for foreign medical graduates who were matched was substantially higher than the average for those who were not matched. It is also important to note that, among the foreign medical graduates who were matched, those who matched to their preferred specialties had higher scores, on average, than those who matched to programs in non-preferred specialty areas.

On the USMLE Step 1, the mean score for foreign medical graduates was 233.8, with a standard deviation of 17.0. The NRMP notes that this is “well above” the minimum passing score in 2016, which was 192. Similarly, on the USMLE Step 2 CK,  the mean score for foreign medical graduates was 238.8, with a standard deviation of 15.6. Again, this was considerably higher than the 2016 minimum passing score of 209.

Looking at this data, there are a few key lessons for foreign medical graduates. Most importantly, it makes sense to dedicate a lot of time and energy to studying for the USMLE Step 1 and USMLE Step 2 CK exams. However, if your scores aren’t as high as those reported above, don’t despair! The data are all based on averages, and there are lots of other places in your application where you can make up for a lower score and show that you are ready for success in a US medical residency program.

Also, even though the data shows that the USMLE Step 1 and Step 2 CK can significantly impact the matching process for foreign medical graduates, you should not forget the importance of the USMLE Step 2 CS. It may not play as large a role on your application, but it is still considered by application readers. Moreover, it is essential for ECFMG certification, so you need to make sure you are ready to pass when test day arrives. Similarly, if you make the choice to take the USMLE Step 3 before you begin your residency, you need to make sure that you are well-prepared so that your score reflects your knowledge and abilities in the field of medicine.

As 2017 comes to a close and the 2018 residency match draws near, FMG Portal is here to help! Contact us today to learn more about what we offer!