The Residency Match Process: How the Match Works, Step by Step

1. You apply to residency programs through the Electronic Residency Application Service (ERAS), interview with programs, and rank preferred programs through the National Resident Matching Program (NRMP)’s R3 system
2. Programs rank their applicants.
3. The NRMP then runs its algorithm to pair applicants with programs based on rank order lists.
4. During Match Week in March, you’ll find out whether you matched and where.

I’m Dr. Amar Mandalia. I’ve been through the Match myself, served on admissions committees, and helped hundreds of students navigate the residency application process. In this guide, I’ll walk you through how the Match works, from submitting your ERAS application to creating your rank order list and navigating Match Week.

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How Does the Residency Match Work?

Matching into residency means the NRMP has paired you with a residency program through the Match algorithm. Your match is based on your rank order list and the program’s rank order list. The program you match into is where you’ll complete your residency training.

The Match process for medical residency can be broken down into six basic steps:

1. Register with ERAS and the NRMP. You’ll use ERAS to apply to residency programs and the NRMP to participate in the medical school matching process.
2. Submit your residency applications. Your ERAS application includes your personal statement, experiences, letters of recommendation, USMLE or COMLEX-USA transcripts, and any other required application materials.
3. Interview with residency programs. Programs review applications and invite selected applicants to interview.
4. Create and certify your rank order list. After your interviews, you rank the programs where you’d be willing to train in order of preference through the NRMP’s R3 system. Residency programs create their own rank order lists of applicants.
5. The NRMP runs the Match algorithm. The algorithm considers both applicants’ and programs’ preferences to determine which applicants are matched to which programs.
6. Find out your results during Match Week. On Monday of Match Week, you learn whether you matched. On Friday, Match Day, you find out which program you matched into. Unmatched applicants may be eligible to participate in the Supplemental Offer and Acceptance Program (SOAP) to pursue unfilled residency positions.

The Match uses an applicant-proposing algorithm. That means the process starts with each applicant's most preferred program and then works down the applicant's rank order list.

For example, imagine two applicants, Applicant A and Applicant B, are both ranking two programs:

Applicant A

1. Program 1
2. Program 2

Applicant B

1. Program 1
2. Program 2

Program 1 has one available position and ranks Applicant B higher than Applicant A. The algorithm considers both for Program 1, but Applicant B receives a tentative match because the program prefers Applicant B. Applicant A then moves to their next choice, Program 2. If Program 2 has a position and has ranked Applicant A, Applicant A receives a tentative match there.

A tentative match means an applicant is currently matched to a program, but the Match can change as the algorithm continues to run. If a higher-ranked applicant reaches that program later, they may take the spot, and the first applicant moves to their next choice. The algorithm continues this way until applicants have either been matched or their rank order lists have been exhausted.

The Match is based on the work of economists Alvin Roth and Lloyd Shapley, who received the Nobel Prize in 2012 for their contributions to matching theory. Before the Match, programs could make offers to students individually, sometimes years before graduation. As the process became increasingly competitive and less fair, they developed a centralized Match to standardize it across the board.

Understanding how the Match works is a great start, but matching into residency requires a strategic approach. In the video below, we walk you through key steps for improving your chances of matching into your preferred residency program.

2027 Residency Match Timeline

Most residency positions are offered through ERAS. The timeline varies each year, but it generally starts in June, culminates with the Match in March of the following year, and ends in May.

The 2026-2027 ERAS Residency Timeline is as follows:

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Match Program Outliers

While most programs operate through ERAS and the Match, several programs operate outside of this structure or alongside it:

• The Military Match: Applicants in the military participate in the Joint Graduate Medical Education Selection Board (JGMESB) process, which runs separately from the civilian Match. For the 2026-2027 cycle, applications are due by Oct. 15, 2026. The Military Match takes place Nov. 16-20, 2026, with results released Dec. 9, 2026.

• The Urology Match: Urology applicants apply through ERAS but participate in the separate Society of Academic Urologists (SAU) Urology Match. For the 2026-2027 cycle, rank lists are due Dec. 28, 2026, and Match Day is Feb. 1, 2027.

• Ophthalmology Match: Ophthalmology applicants use the Central Application Service (CAS) and match through the San Francisco Match (SF Match). For the 2027 cycle, preliminary match results are released Jan. 22, 2027; full match results are released Jan. 25, 2027.

Most preventive medicine residency programs now participate in the NRMP Match, but applicants should still contact individual programs to confirm their application process and timeline.

ERAS vs. NRMP

It is important to understand that the residency application process and the residency matching process are administered by two separate entities:

• ERAS is administered by the Association of American Medical Colleges (AAMC).

• Rank order lists (ROLs) and the Match are administered by the NRMP.

You’ll need to register for both systems for most residency applications to match.

ERAS allows you to package your application and send it to programs, which will then offer you interviews.

NRMP allows you to make and submit a ranked program list from your most to least desirable residency training programs. Then, the algorithm matches you.

Related Read: Average Residency Salary by Specialty + Job Level

The ERAS Application

To increase your chances of matching into your preferred residency, prepare your ERAS application well before the September submission date. For a detailed walkthrough, read our ERAS application guide.

Below are the main sections of the ERAS application you’ll complete as part of your residency application:

• Personal and Biographical Information: Enter or confirm your basic demographic, contact, and identity information.

• Experiences: Highlight up to 10 clinical, research, volunteer, shadowing, leadership, and other relevant experiences, including three designated as most meaningful. The ERAS Experiences section is similar to the AMCAS Work and Activities section, but has its own requirements. Learn more about how to approach the ERAS Experiences section.

• Personal Statement: Use your personal statement to describe your interest in the specialty in detail and what you would bring to a residency program. Read our ERAS personal statement guide to help you craft a standout essay.

• Scholarly Work: Enter your research, publications, presentations, and other scholarly activities using the categories provided in ERAS. Learn more about the ERAS Scholarly Work section.

• Letters of Recommendation: Request letters early and follow each program's requirements for the number and type of letters needed.

• Medical Student Performance Evaluation (MSPE): Also known as the Dean’s Letter, the MSPE summarizes your academic performance, progress, and professional attributes. For U.S. applicants, your Dean’s office will upload the MSPE to ERAS.

• Medical School Transcript: Your medical school submits your official transcript through the Designated Dean's Office.

• ECFMG Status Report: IMGs may need an ECFMG Status Report documenting their certification status and other information relevant to their residency application.

• Photograph: You may include a photograph with your application. I recommend including a professional headshot to slightly increase your chances of an interview invite.

• USMLE and COMLEX-USA Transcripts: Include your board exam transcripts as required by programs. With Step 1 now pass/fail, USMLE Step 2 CK is an important part of many residency applications. Learn more about Step 2 CK scores.

Some specialties also include Specialty Questions within the ERAS application. Check the requirements for each program and specialty before submitting your application.

Do I need to submit a CV? You don’t need to create a separate CV apart from your application. The CV compiled in the MyERAS portal is an auto-populated document that includes information found elsewhere in your application.

If you’d like to have a copy of this document, you can download it by selecting “View/Print CV” in the same area where you can print the entire ERAS application.

Want more guidance on building a strong residency application?

Residency Interviews

Residency interviews typically take place from the fall through early winter. Many programs continue to offer virtual interviews, while some have returned to in-person interview days. Review each program’s format and prepare accordingly.

You can expect questions like these during a typical residency interview:

• Why did you want to become a physician?

• What makes you want to pursue this specialty?

• What are your greatest strengths and weaknesses?

• What interests you about this specific program?

• Describe a research project you were involved in.

• What would you do if you saw a senior resident or attending do something wrong?

For more examples, read our guide to Residency Interview Questions and Answers.

Now, let me offer some tips for your residency interview:

• Attire: Dress professionally and choose neat, presentable clothing that does not distract from you as a candidate.

• Body language: Sit upright and demonstrate engagement through your posture and eye contact. For virtual interviews, look toward the camera when speaking.

• Virtual setup: Choose a well-lit, quiet space with a professional background and test your technology before the interview.

• Ask questions: Come prepared with thoughtful questions about the program, its residents, workplace culture, and what makes a resident successful there.

See our detailed guide to residency interview tips for more.

After completing your interviews and before submitting your rank order list, consider sending a letter of intent to the program you intend to rank first. These can double as thank-you notes, which you should send to every place you interviewed.

Our Physician Advisors have helped thousands of med students stand out in their residency interviews. Learn how 1-on-1 interview prep from MedSchoolCoach can help you prepare for your interviews and match into your preferred program.

Ranking Programs on Your Rank Order List

Creating your rank order list (ROL) is straightforward, but it requires important decision-making. During the 2027 Match, applicants can create and edit their lists in the NRMP’s R3 system from Feb. 1 through March 3, 2027. Your list only counts once you have certified it by the March 3 deadline.

Only rank programs where you would actually accept a position, and rank them in your true order of preference, with your most preferred program at the top. Don’t try to predict where you’re most likely to match or rearrange your list based on how competitive you think you are.

The NRMP algorithm works from the applicant’s preferences. Ranking a program lower never improves your chances of matching there. If the algorithm can’t place you at your first choice, it moves down your list to your next preference, so the best strategy is to rank programs in the order you genuinely prefer them.

Important note: Once you certify your rank order list, you can’t make changes unless the NRMP reopens the list.

Couples Match on the ROL

The Couples Match is for any two individuals who want their match to be contingent on where their partner matches. Really, you don’t have to be romantically involved with the other person — you can Couples Match with anyone, although I wouldn’t recommend it.

The Match algorithm matches couples as pairs, not individual programs. See our detailed guide to the Couples Match to learn more about how it works.

There is absolutely no requirement to have the same specialty or the same location. There are many reasons you might pair programs where you interviewed with programs where your partner interviewed. Just keep the “No Match” codes for the end of your ROL.

If you or your partner is applying to an advanced program (PGY-2), you’ll need to add a supplemental rank order list. Fees may quickly stack up when adding supplemental ROLs for preliminary or transitional programs.

Learn More: Categorical vs. Preliminary vs. Advanced Residency Programs

Contiguous Ranks on the ROL

Contiguous ranks are the number of programs in the same specialty that appear consecutively on your ROL. You can rank programs in one specialty consecutively or alternate between specialties, depending on your preferences.

Example A: Prioritizing specialty

Applicant A is most interested in dermatology, so they rank three dermatology programs before two pediatrics programs:

• Dermatology program 1

• Dermatology program 2

• Dermatology program 3

• Pediatrics program 1

• Pediatrics program 2

Applicant A has three contiguous ranks in dermatology and two in pediatrics.

Example B: Prioritizing program

Applicant B is interested in both dermatology and pediatrics and cares more about the individual programs than the specialty:

• Dermatology program 1

• Pediatrics program 1

• Dermatology program 2

• Pediatrics program 2

• Dermatology program 3

Applicant B has no contiguous ranks because the dermatology programs are separated by pediatrics programs.

The number of contiguous ranks can matter when you're trying to match into a specific specialty. In the 2026 Match, for example, U.S. MD seniors who matched to their preferred anesthesiology specialty had a median of 13 contiguous anesthesiology ranks. The latest Charting Outcomes report from the NRMP shows similar patterns across specialties.

However, you can still rank programs across multiple specialties. Review the Match data for the specialties you’re considering, but ultimately rank programs according to your true preferences.

Related: Least Stressful Medical Specialties With Good Work-Life Balance

Match Week

Match Day residency results are announced at the end of Match Week. In 2027, Match Week runs from March 15-19 and includes several important events:

• Monday, March 15: At 10 a.m. ET, applicants learn whether they matched through the NRMP. They won’t learn where they matched yet.

• Monday-Thursday: Applicants eligible for SOAP can apply to unfilled residency positions and participate in the SOAP process.

• Thursday, March 18: SOAP offers are made in four rounds throughout the day.

• Friday, March 19: Match Day takes place at 12 p.m. ET, when applicants learn where they matched.

What Happens If You Don’t Match? Explaining SOAP

The Supplemental Offer and Acceptance Program (SOAP) is designed to fill gaps left by the algorithm for applicants who didn’t get matched and for program spots that went unfilled.

On Monday of Match Week, applicants are notified if they are eligible for SOAP. To be eligible for SOAP, you must be:

• Unmatched or partially matched.

• Registered in the Main Residency Match through NRMP.

• Available to start residency on July 1.

SOAP works differently from the Main Residency Match. There is no applicant-proposing Match algorithm. Instead, SOAP-eligible applicants can access a list of unfilled program positions through the NRMP website and apply to programs through ERAS.

Programs may interview applicants by phone or virtually over the next couple of days. You’re not allowed to contact programs during this time unless they initiate contact with you. Programs, not applicants, submit a new rank order list of candidates they’ve interviewed.

Based on these lists, SOAP offers are extended on Thursday of Match Week. For the 2027 Match, there are four rounds of offers on Thursday, March 18. Most SOAP positions are filled in the first round. Applicants who remain unmatched after a round can continue through the subsequent rounds until the conclusion of all rounds.

Once SOAP ends on Thursday evening, applicants who are still unmatched receive a final list of unfilled programs. Now, the rules change: You may contact the programs on that list and ask for interviews. They can extend an offer to you at any time before the end of the application cycle.

Read more about SOAP on the NRMP website.

Residency Match Rates

The 2026 Main Residency Match included 48,050 active applicants, with 38,354 matching to a PGY-1 position, for an overall match rate of about 80%.

Match rates varied by applicant type:

• U.S. MD seniors: 93.5%

• U.S. DO seniors: 93.2%

• U.S. citizen IMGs: 70%

• Non-U.S. citizen IMGs: 56.4%

The number of residency positions continues to grow in specialties such as internal medicine, family medicine, emergency medicine, psychiatry, and general surgery, although fill rates vary by specialty and applicant type.

If you’re deciding which specialty or subspecialty to pursue, learn more in our guide to the most competitive medical residencies.

Important Notes for IMGs

International medical graduates (IMGs) are medical students or graduates who attended medical school outside the U.S. In the 2026 Main Residency Match, the PGY-1 match rate was 70% for U.S. citizen IMGs and 56.4% for non-U.S. citizen IMGs.

IMGs should research programs carefully and look for those with a track record of matching international graduates. Our guide to IMG-friendly residency programs can help you identify programs to consider. You can also use the Residency Explorer tool to see how many IMGs have matched into specific programs.

If you need visa sponsorship, check each program's requirements before applying. Programs may have different policies regarding which visas they sponsor.

Note: For medical school graduates in the class of 2026 and beyond, Canada and the U.S. will no longer practice reciprocity and will consider graduates of the other country as IMGs.

FAQs

Maximize Your Odds on Match Day

The residency application process is a long road that requires careful planning. In the 2026 Main Residency Match, about 80% of active applicants matched to a PGY-1 position. Starting early and approaching each step strategically can help you put your strongest application forward.

Stay ahead of the curve by investing in 1-on-1 mentorship throughout the residency application process, from carefully selected audition rotations all the way to Match Day.

We match 99% of US clients and 88% of IMG clients into residency. Build your application alongside a Physician Advisor with experience on admissions committees.