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!