Supplemental Rank Order List: A Step-by-Step Guide for Advanced and Preliminary Programs

How to rank preliminary and advanced programs on NRMP

Meet Sarah: The Aspiring Anesthesiologist

Supplemental Rank Order List Example- Sarah is a meticulous medical student with her sights set on Anesthesiology Residency Programs. Advanced Anesthesiology programs begin at PGY-2 and require applicants to first complete a Preliminary Year (PGY-1). Like other Advanced specialties, such as Dermatology, Neurology, and Radiology, the path to Anesthesiology necessitates careful planning to organize two critical elements on the Rank Order List (ROL): a Preliminary Year (PGY-1) and an Advanced Position (PGY-2).

Here’s how Sarah tackled the ROL process methodically.

Step 1: Understand the Basics

Advanced Anesthesiology Programs start at PGY-2. To qualify, Sarah needs to complete a Preliminary Year. Her options for PGY-1 included:

• Transitional Year (TY): A curated sampler of clinical rotations.
• Internal Medicine (IM): A year steeped in diagnostic rigor and long-form patient care.
• Surgery: A crucible of procedural intensity and relentless pacing.

Sarah opted for a mix of TY and IM programs, drawn to their balanced curricula and the opportunity to refine her clinical acumen before entering the OR.

Step 2: Divide and Conquer the Rank Order List

Sarah’s ROL required a dual-layered approach:

• Advanced Programs (Anesthesiology): The pinnacle of her efforts.
• Preliminary Programs (TY or IM): The foundation supporting that pinnacle.

The Advanced Section:

Sarah ranked her Anesthesiology programs based on her true preferences.

The Preliminary Section:

She curated a separate list for PGY-1 preferences, prioritizing programs like TY at Dream Hospital and IM at Good Vibes Medical Center.

Step 3: Link the Lists

Sarah utilized the Supplemental Rank Order List (SROL) feature, which allowed her to link Advanced programs with her preferred Preliminary options. This ensured alignment between her PGY-2 and PGY-1 matches.

Example:

• Main ROL:
  • Dream University (Advanced Anesthesiology)
  • Cool Program (Advanced Anesthesiology)
• SROL for Dream University:
  • TY at Dream Hospital
  • IM at Good Vibes Medical Center
  • TY at Chilltown Community

If Sarah matched at Dream University for Anesthesiology, the algorithm would prioritize her linked Preliminary options from the SROL.

Step 4: What About Categorical Programs?

To safeguard against the uncertainties of the match process, Sarah also applied to a few Categorical Internal Medicine programs. These programs provide a direct path from PGY-1 to PGY-3 within Internal Medicine, offering a secure backup option. She interspersed these among her Advanced program preferences on the main ROL.

Step 5: Sarah’s Final ROL

Here’s what Sarah’s ROL ultimately looked like:

1. Advanced Anesthesiology Program A (linked to her TY/IM SROL).
2. Advanced Anesthesiology Program B (linked to her TY/IM SROL).
3. Advanced Anesthesiology Program C (linked to her TY/IM SROL).
4. Categorical IM Program A (backup).
5. Categorical IM Program B (backup).

Her linked SROLs ensured a seamless alignment between her Advanced and Preliminary positions.

Step 6: Avoiding Common Pitfalls

Sarah’s mentor provided practical advice to navigate the process effectively:

• Rank by Genuine Preference: The algorithm prioritizes authenticity in your rankings.
• Consider Geographic Compatibility: Avoid Preliminary programs that are logistically incompatible with your Advanced choices.
• Always Have a Backup: Include Categorical programs as a contingency.

Step 7: A Perspective Worth Considering

Finalizing her ROL was more than a logistical exercise for Sarah; it was an opportunity to align her ambitions with reality. The process required careful reflection and strategic planning to ensure her choices were well-considered and achievable.

Final Thoughts

Sarah’s approach to her ROL illustrates the importance of deliberate and strategic thinking. Whether you’re pursuing Anesthesiology, Dermatology, or any other Advanced specialty, crafting your ROL thoughtfully ensures alignment between your aspirations and your goals, setting you on the path to success.

NRMP- About Supplemental Rank Order Lists Ranking different specialties and different categories

IMGPrep Match Smarter Not Harder!!

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