A. The NRMP matches applicants and programs in favor of the students. Students get their highest ranked programs when the programs rank them highly; residency programs do not get their highest choices when students have ranked other programs higher. Given that mechanism, it follows that:
1. Rank your first choice first, even if you feel your chances of matching are low.
2. List five to seven programs, even if you are confident of your top three. If your academic record is uneven, you may want to list more than seven.
3. Consider having a "safety" program ranked at the bottom. Not matching is problematic, even though there are usually good programs which do not fill.
4. DO NOT rank a program that you really do not want to go to. You break a legal contract if you do not attend a program you matched, and it is foolish to go where you would be unhappy. You are better off NOT matching, and then scrambling for a spot.