A residency letter of intent tells one program you plan to rank it first. The NRMP allows applicants to express interest, but many specialties now discourage these letters, and the AAMC says they rarely change rankings. Here are the 2027 Match rules, what each specialty’s program directors say for the 2026-27 cycle, and how to write one if you send it.
From NRMP, AAMC, and specialty program director associations2027 Main Residency MatchChecked October 29, 2026
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What the NRMP rules say
The 2027 Match Participation Agreement allows voluntary expressions of interest in both directions. Section 6.4: “Applicants may voluntarily communicate their interest to a program(s); however, applicants may not solicit verbal or written statements from a program(s) implying a commitment to rank the applicant.” (NRMP 2027 MPA)
Programs may not pressure you. Under Section 6.5, programs are not authorized to “Request that applicants reveal their ranking preferences” or to “Suggest or inform applicants that placement on a rank order list or a SOAP preference list is contingent upon submission of a verbal, electronic, or written statement indicating the applicant’s preference.”
The only binding commitment is the Match itself. For 2027, ranking opens February 1, the rank order list deadline is March 3 at 9 p.m. ET, and Match Day is Friday, March 19 (NRMP calendar).
What each specialty says (2026-27)
Each specialty’s program director association publishes guidance in the Program Director Associations Guides for Residency Applicants. On post-interview communication for the 2026-27 cycle:
| Specialty | Guidance |
|---|---|
| Dermatology | Letters of intent and thank-you letters “should not be sent to programs.” |
| Plastic surgery (integrated) | Post-interview contact is “against the policy set forth by ACEPS and should not be done.” |
| Family medicine | “Applicants are discouraged from sending letters of interest or intent to rank.” |
| Internal medicine | Programs should tell interviewees to “refrain from sending “thank you” notes.” |
| Psychiatry | “No post-communication aside from a simple thank-you is recommended.” |
| Pediatrics | “Letters of intent are not expected and if sent, should only be sent to one program.” |
| Anesthesiology | A thank-you note or letter of interest is welcome, but it “will not be utilized to influence interview/rank list outcomes.” |
| General surgery | “Thank you letters or post-interview communication is acceptable but not required.” |
| Diagnostic radiology | Generally not required. “Usually, programs will give guidance.” |
| Obstetrics and gynecology | Programs are asked to be transparent about their preferences on thank-you notes and letters of intent. |
| Urology (AUA Match) | Applicants may write thank-you notes. “Programs should not respond to thank you notes.” |
What programs say
The AAMC says letters of interest “In most cases, they have little to no impact on ranking decisions.” It adds: “It is important to follow each program’s stated communication guidelines, as failing to do so may negatively affect your application.” (AAMC)
Program pages make this concrete. Kansas OB-GYN does not recommend post-interview communication, including thank-you notes, and says “Communication from candidates about rank order or preference are highly discouraged and may be considered match violations.” (KU OB-GYN) Mayo Clinic Arizona internal medicine, in the NRMP rank list lock pilot for 2027, says “we limit post-interview communication to answering clarifying questions about the program.” (Mayo Clinic Arizona)
Should you send one?
- Check the specialty and the program first. If either says not to, don’t. Dermatology, plastic surgery, and Kansas OB-GYN are clear.
- Send it to one program at most. Pediatrics says so directly, and telling two programs they’re first is dishonest.
- Don’t ask for anything back. Applicants may not solicit statements implying a commitment to rank them (MPA 6.4).
- Rank by your true preferences anyway. A letter doesn’t change the algorithm, and the Match result is binding.
- Time it before the rank list deadline. Ranking opens February 1, 2027 and closes March 3.
Example residency letter of intent
We wrote this as a teaching example; it is not a real applicant’s letter. Keep yours this short: who you are, the date you interviewed, that you will rank the program first, and two specific reasons.
Example: A letter of intent to a residency program director
Dear Dr. Haddad,
Thank you for my interview with your internal medicine program on December 4. I’m writing to let you know that I plan to rank your program first.
Two things stood out. Your residents run the night float as a team, not as solo coverage, and the third-year who showed me around talked about it as the best teaching of the year. I also liked that your ambulatory blocks run on a fixed 4+1 schedule, so clinic patients see the same resident all three years.
I know programs can’t ask applicants how they plan to rank, and I’m not asking anything of you in return. I’m telling you because it’s true, and you are the only program I’m sending this to.
Best,
Hana Sato, MS4
AAMC ID 87654321
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Still working on your application? See our residency personal statement examples and our residency interview guide. Applying to fellowship? See the fellowship interview guide. For medical school waitlists, see medical school letters of intent and update letters.
Frequently asked questions
Are residency letters of intent allowed?
Yes, under the NRMP Match Participation Agreement applicants may voluntarily communicate their interest to a program. Some specialties, including dermatology and plastic surgery, say not to send them, so check the specialty and program first.
Is a residency letter of intent binding?
The only binding commitment in the NRMP Match is the Match result itself. Still, telling a program you will rank it first is a promise you should keep.
Do letters of intent change how programs rank applicants?
Rarely. The AAMC says that in most cases they have little to no impact on ranking decisions, and anesthesiology’s guidance says such letters will not be used to influence rank list outcomes.
Can a program ask me how I will rank them?
No. The 2027 Match Participation Agreement does not authorize programs to request that applicants reveal their ranking preferences, or to make ranking contingent on a statement of preference.
When is the 2027 rank order list deadline?
Wednesday, March 3, 2027 at 9 p.m. ET. Ranking opens February 1, 2027, and Match Day is Friday, March 19, 2027.
Every rule and quotation on this page comes from the NRMP, the AAMC, the Program Director Associations Guides for 2026-27, or the program’s own page, linked where it appears. Last checked October 29, 2026.