Building Your Rank Order List

Your rank order list (ROL) is the one document you fully control in the Match. The rule is simple: list every program where you would be willing to train, in the order you truly prefer them. This page explains how to apply that rule when your interview count is limited and your visa may restrict you. For why the rule works, see how the Match algorithm works. The glossary entry for Rank order list has a quick definition.

The core rule #

NRMP's algorithm is applicant-proposing: it tries your first choice first and moves down only if you cannot be placed. Because of that, your best strategy is to rank by true preference. Do not move a program up because you think it likes you, and do not move a program down because you think it is a long shot. The algorithm already handles the probabilities; your job is to state your preferences.

Step by step #

1. Gather your interview list. Only programs where you interviewed or that you are eligible to rank can appear. You can rank a program you did not interview with if the program ranked you, but check NRMP rules and the program's expectations.
2. Remove programs you would not attend. A match is a binding commitment under the Match Participation Agreement. Do not rank a program you would not train in.
3. Decide your criteria. Common ones: training quality and case mix, supervision and teaching, resident satisfaction, visa sponsorship, location and family, cost of living, fellowship outcomes and how the program treats IMGs.
4. Score or sort, then rank. A simple weighted table helps, but override it with your gut if the numbers feel wrong. Your final list is your preference, not a formula's.
5. Review the list for logic. Does the top reflect where you would be happiest, not where you think you will be matched?
6. Certify by the deadline. Your list is not final until it is certified in NRMP's system. Do not wait until the last day.

Questions IMGs ask #

How many programs should I rank? #

There is no fixed number. In NRMP's 2026 Charting Outcomes report for non-U.S. citizen IMGs, matched applicants had a median of 5 contiguous ranks in their preferred specialty, compared with 2 for those who did not match. This means the practical lever is getting enough interviews, and ranking every acceptable program. NRMP charges extra fees for longer lists; check the current NRMP fee page rather than relying on any figure here.

Should I rank programs in a second specialty? #

Only if you would truly train there, and only if you applied and interviewed. Remember a list for two specialties is common practice for some applicants, but each match is binding. NRMP's data shows 1.0 as the median number of distinct specialties ranked by non-U.S. citizen IMGs in 2026, so most rank in a single specialty.

What about preliminary programs? #

A preliminary position is one year only. If you rank one, understand what it does and does not lead to. Read Preliminary year and Categorical position, and ask programs about their pathway.

How do I handle visas? #

If a program cannot sponsor your visa type, it cannot realistically train you. Confirm sponsorship in writing where possible and consider it when ranking. See J-1 vs H-1B.

Does it help to tell programs where I will rank them? #

You may express interest, but you do not have to, and NRMP says programs cannot ask you to disclose your ranking or imply ranking depends on a statement of intent. If a program says it will rank you highly, treat it as non-binding; the algorithm does not consider promises.

What if I want to match with my partner? #

NRMP allows couples to participate and submit linked lists. A couple will match to the most preferred pair of programs on their combined lists that can accommodate both. In the 2026 Match, NRMP reported 1,258 couples, and 93.0 percent had at least one partner match. Read NRMP's couples rules carefully before building your pair list.

IMG-specific deadlines and verification #

• ECFMG verification. NRMP requires IMGs to be verified by ECFMG as having met the examination requirements by the rank order list certification deadline, otherwise they are withdrawn and cannot participate in the Match or SOAP. Verification status appears in NRMP's R3 system. See ECFMG.
• ECFMG certification itself is required before you start residency. See ECFMG's certification page (or the wiki's ECFMG guides).
• Update contact information in R3 so you receive notices.

Common mistakes #

• Ranking by perceived chance of matching rather than preference.
• Leaving off a program you would accept, shrinking your options.
• Ranking a program you would not attend because you think you will not match there.
• Letting a program's pressure or promises change your order.
• Missing the certification deadline or ECFMG verification.
• Not reading the Match Participation Agreement.

Before and after you certify #

Before certifying, ask a trusted mentor to read your list. After certifying, you cannot change it, so check each program name and its position type (categorical, preliminary, advanced). After the Match, if you are unmatched or partially matched, see Match Week timeline and if you do not match.