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The Tip of the Iceberg: Improving the Quality of Rank Order Lists for the Match

Baker, Keith MD, PhD

Academic Medicine:
doi: 10.1097/ACM.0b013e31829ed3eb

Many factors limit the ability of resident selection committees to reliably determine which medical student applicants will be top performers in their internship and residency programs. Resident selection committees expend significant time and effort to read applications and then interview and score applicants, all with the goal of creating a rank order list (ROL) for the National Residency Matching Program. Although much of the information used in this process is outside the control of the selection committee, one factor they can control is how they use committee member scores to create the ROL. ROLs are typically generated using the average score assigned by committee members. With this approach, a single harsh faculty member can strongly influence the rank order of applicants if he or she scores only some of the applicants.

The author of this commentary discusses the challenges inherent in the creation of ROLs and examines a new approach, described by Ross and Moore in this issue, that can eliminate the problem of biased scoring. ROLs created using this new ROSS-MOORE (Recruitment Outcomes Simulation System–Moore Optimized Ordinal Rank Estimator) approach will better represent the rank ordering of each faculty member of the selection committee. However, ROLs will remain poorly predictive of future performance in internship and residency programs until evaluative data supplied by medical schools are more accurate in predicting which students will become excellent physicians.

Author Information

Dr. Baker is assistant professor of anesthesia, Harvard Medical School, and assistant anesthetist, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.

Funding/Support: None.

Other disclosures: None.

Ethical approval: Not applicable.

Correspondence should be addressed to Dr. Baker, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit St., Jackson 4, Boston, MA 02114; telephone: (617) 726-3030; fax: (617) 724-5800; e-mail:

© 2013 by the Association of American Medical Colleges