If your best friend had to live your match life for the next three years, which program would you choose for her?

That is the question I ask every applicant who messages me in full panic while building their rank list. Not what looks best on paper. Not what your aunt’s friend’s cousin thinks is prestigious. Not even who gave you the fanciest interview day breakfast spread. If your best friend had to wake up at 4 a.m. for call, learn from those attendings, eat lunch in that lounge, and build her medical identity in that hospital, where would you send her?

Because the truth is, your rank list should reflect where you will thrive. Not where you think you should want to be.

Here’s the thing no one tells you: interviews are a first date. Everyone is on their best behavior. The sparkling personality, the warm welcome, the perfect answers. But your rank list should be based on what you felt when you closed your laptop or walked out of the building. That quiet inner tug that said, “I could belong here.” Or the equally strong one that said, “Nope.”

Start by asking yourself the real questions. Who made you feel respected? Who listened when you talked about your goals? Who cared about you as a person, not just an applicant? Those moments matter. Programs rarely change personality. What you saw is what you will get.

Then think about the residents. Could you see yourself learning from them? Laughing with them on a busy clinic day? Did they look exhausted in a worrying way or in a normal resident way? Residents are the heartbeat of a program. How they carry themselves tells you almost everything.

The next step is to ignore the noise. People will have opinions. They always do. But the match algorithm is designed to protect your choices. Rank in the order you want, not what you think will “look smart.” I promise you the most miserable residents I’ve met were the ones who matched somewhere they thought they were supposed to want, not somewhere they felt at home.

Consider your future self too. Where do you want to grow? Who will make you confident? Which program will allow you to make mistakes safely, teach you with patience, and help you find your voice?

Your rank list is not about impressing people. It’s about building the next version of you. The one who will show up for patients in the middle of the night. The one who will learn procedures that could change a life. The one who will look back and say, “This is where it all clicked for me.”

So ask yourself that question again. If your best friend had to live your life for the next three years, where would you send her?
That answer is your number one.

Everything else falls into place after that.