Canadian medical graduates and US allopathic medical graduates
Click on an FAQ below to view the response.
What does CaRMS do?
CaRMS is a not-for-profit, fee-for-service organization that works in close cooperation with the medical education community, medical schools and residents/students to provide an electronic application service and a computer match for entry into postgraduate medical training throughout Canada.
Using the Match Algorithm, CaRMS matches over 3,500 applicants each year to postgraduate medical training programs in Canada through four residency matches:
- R-1 Main Residency Match
- Family Medicine/Emergency Medicine Match
- Medicine Subspecialty Match
- Pediatric Subspecialty Match
Click on the match names above for specific information on the processes, requirements and timelines for each match.
We are committed to working with you to make the application and matching processes as simple and straightforward as possible. We do our best to keep you informed throughout the match year by apprising you of important dates (called milestones) and other information that can aid you in your application both through email communiqués and by updating our Facebook page and Twitter feed.
Which browser should I use to have the best CaRMS Online experience?
We recommend you use a supported browser for the best CaRMS Online experience. We test all system functionality in our supported browsers and fix any issues we find. While we will not block users from using unsupported browsers, we may not be able to fix problems users encounter when accessing CaRMS Online on an unsupported browser.
CaRMS supports the following browsers:
|Applicant users||Program, file review, undergraduate and referee users|
|Internet Explorer 11||Internet Explorer 9, 10, 11|
For more information on our browser support model, visit CaRMS.ca/en/browser-support/.
Is there anything CaRMS does not do?
There are several common misconceptions about CaRMS. CaRMS does not:
- Make decisions regarding program descriptions, position quota, distribution or criteria;
- Set up interviews or have input in the selection process; or
- Provide specific strategic advice.
Although CaRMS administers the matches, all decisions regarding programs registered in the match, quota, distribution, criteria, interviews and selection are made by the participating postgraduate institutions. While we can provide practical advice about how to access and use our services, for strategic advice you should turn to your faculty advisor or career counselor.
What are my rights as an applicant?
Your rights as an applicant are defined by applicable human rights legislation that is intended to ensure all individuals have equal employment opportunities without regard to: race, colour, national or ethnic origin, religion, age, family or marital status, sex, a pardoned conviction, disability, or sexual orientation. Human rights legislation is not intended to prevent candidates from being chosen based on skills that are required for the position. A particular skill or qualification can be specified if the preference is based on a bona fide occupational requirement.
Is my information safe?
CaRMS places the highest value on ensuring the confidentiality and security of sensitive data and personal information. CaRMS’ online systems incorporate a multi-tiered approach to security that comprises industry standard data encryption, user credential authentication, server decoupling and a redundant firewall network infrastructure.
How do I get started?
To get started, review the information in the match pages, including the eligibility and provincial criteria. When you are ready to begin, you can find registration information in the match pages. Note: you cannot register an account until you are eligible for a match.
Is there a fee associated with the CaRMS application?
All applicants are required to pay a registration fee to participate in the CaRMS match, as well as program application fees. CaRMS is a not-for-profit, fee-for-service organization. Therefore, all fees for registration and application, including those received from applicants who later withdraw or are unmatched, are non-refundable.
Please consult our fees page for more detailed information.
What information should my application include?
As an applicant, you can fill in the required information for training directly into our online system. You are also able to upload and/or request the required documents for your application. Some documents (transcripts, MSPRs) are provided to CaRMS directly from Canadian medical schools.
Any official documents that are not notarized or sent directly from the source are marked with a “copy” stamp. For example, reference letters should be sent directly from the referee to CaRMS whenever possible, but when necessary, you are also able to submit notarized copies yourself.
A typical postgraduate residency application includes:
Input the required personal information (e.g., date of birth, gender, citizenship).
Identify your language proficiency in English, French and/or any other language. Only include languages that you can read, write and speak fluently.
Enter information about medical licensure. Canadian medical graduates (CMGs) usually will not have a medical license until they have completed their residency training and all Medical Council of Canada (MCC) exams. Many international medical graduates (IMGs) will have a medical license. Note: Completing all the MCC exams and obtaining your Licentiate of the Medical Council of Canada (LMCC) certificate does not necessarily mean that you have your license to practice medicine in Canada.
Achievements and interests
Record your academic achievements (e.g., honours and awards, leadership/administrative positions in medicine, memberships, associations and committees, other accomplishments) and areas of interest you would like to provide to the programs.
Undergraduate education and CÉGEP
Record your undergraduate education (completed or not). Undergraduate education is any schooling you received after completing high school and before beginning medical school (e.g., Bachelor’s degree, CÉGEP, pre-med).
Record your graduate education (completed or not). Graduate education is any schooling you received after completing your undergraduate education (e.g., Master’s degree, Doctorate).
Record where you have earned, or will earn, your medical degree.
Identify any electives that you have, or will have, completed during your undergraduate medical education. An elective is defined as any rotation you have done during your medical education training that was not mandatory.
Record any accredited postgraduate medical residency training you have participated in after obtaining your medical degree.
Record electives you have, or will have, completed during your residency training.
Record any training you have completed that is not directly linked to your medical education.
Record any work experience that is not considered clinical practice but that you consider important. This also includes work that was done prior to obtaining your medical degree. You are encouraged to record work experience that is not necessarily linked to the medical field.
Record volunteer experience or relevant unpaid work for which you did not receive school credit. Volunteer experience does not have to be linked to the medical field. You may record volunteer experience that took place prior to obtaining your medical degree.
Scholarly activities and research
Record your participation in research, as well as organized clinical discussions, rounds, journal clubs and conferences.
Applicants wanting to send publications are asked to send only the abstract. Publications should be confined to peer-reviewed journals.
Record any observerships you have completed. An observership is a period of time spent observing clinical practice, usually with no patient contact. It is also sometimes referred to as a shadowing opportunity. Normally an observership lasts between one week and one month. It does not involve a service commitment or a salary and is non-accredited. Observerships are not electives.
Record any fellowships you have completed. Fellowships are non-accredited programs that are considered additional specialized training experience involving patient contact. Clinical fellows must be able to provide evidence that they are recognized as specialists in the jurisdiction where they are currently practicing medicine. Training as a clinical or research fellow in the Department of Medicine is not accredited nor is it approved as residency training towards certification by the Royal College. Fellowships are not electives.
Record clinical practice experience. This may include paid or unpaid work. For the purposes of the CaRMS application, clinical practice is defined as actively practicing medicine with an independent license without supervision.
Examinations (MCC exams, USMLEs, assessments)
Record examinations you have taken, or are scheduled to take. All examination documents submitted to programs must be current. Some examinations expire after a number of years; it is up to you to ensure that your examination results are currently valid.
Do application requirements vary by province?
Requirements vary by province and by program. You should refer to the program descriptions and provincial eligibility criteria found in the match pages to ensure that you are eligible before you apply.
Are there any differences between Canadians studying in Canadian medical schools and Canadians studying in US medical schools when it comes to the match?
There are no differences between Canadians studying in a Liaison Committee on Medical Education/Committee on Accreditation on Canadian Medical Schools (LCME/CACMS) accredited school in Canada or in the US when it comes to the match. There may be some differences in how documents arrive (e.g., sent directly from the school or uploaded by the applicant) and supporting documentation.
We encourage you to review the eligibility criteria found on the match pages before beginning the application process.
What is a program?
A program is a defined postgraduate medical education training period in a specific discipline accredited by either the Royal College of Physicians and Surgeons of Canada or by the College of Family Physicians of Canada. All programs in the CaRMS match are accredited training programs. Each program name is a combination of the university, the specific discipline and the location where the training will primarily take place.
Is there a limit on how many programs to which I can apply?
There is no limit on the number of programs to which you can apply; however an application fee applies to each program application. Please visit our fees page for more information.
What does it mean when a program has multiple streams?
A program can have multiple streams of application, meaning that the program offers training at more than one site. For example, if a Family Medicine program has a site in London and a site in Windsor, the program has two streams of application. If you are interested in both locations, you must apply to each stream separately.
Can I apply to multiple program streams?
Yes. If you are interested in more than one training location of the same program, you must apply to each stream separately. Each stream counts as a separate application.
Can I submit a bilingual application?
CaRMS accepts bilingual applications in English and French. You may not submit an application in a language other than English and/or French. CaRMS offers English-to-French and French-to-English translation services through CaRMS Online for select documents for all four of our residency matches. Eligible documents include: medical school transcripts, MSPRs and reference materials.
Please note that we do not offer translation of other document types, nor documents in languages other than English and French. This service is only available to applicants submitting bilingual applications.
What can I do to prepare for the match?
We aim to make the residency match process as easy and stress-free as possible. The following tips will help you prepare for your match:
1. Familiarize yourself with program descriptions
CaRMS collects and posts the program descriptions provided by programs of Canadian medical schools participating in each of CaRMS’ matches. These descriptions are publicly accessible in the match pages.
2. Review eligibility criteria
Ensure you read the eligibility criteria and provincial criteria found in the match pages to ensure you meet all the necessary requirements to practice in your chosen province(s).
3. Schedule your electives strategically
Keep in mind that you will need to request reference letters for your CaRMS application, so it is important to line up your electives schedule to ensure you will be in a position to collect the references you need to support your career choices.
4. Consider all the options
Think about applying broadly and consider more than one discipline. CaRMS does not limit the number of programs you can apply to. Applying broadly could increase your likelihood of matching to your preferred discipline or location.
5. Get to know the match timeline
All CaRMS matches operate on approximately the same schedule every year. The timelines provide a schedule of milestone dates to help you keep your application on track throughout your match year, but these milestones are not deadlines. The only real deadline in the CaRMS schedule is the rank order list deadline – the date by which you must submit your ranked list of programs to which you are applying. If you miss this deadline, you will be automatically withdrawn from the match. Be sure to consult the timetable on a regular basis for up-to-date information.
I applied to the first iteration, but I didn’t receive any interviews so I didn’t submit an ROL. Do I need to withdraw to enter the second iteration?
There is no need to withdraw your application at this point. On first iteration Match Day the first iteration match results will be published. Shortly after, you will be able to see what positions are available for the second iteration on the program descriptions page on carms.ca. From the opening of second iteration until file review, you will be able to make changes to your application, assign documents and apply to programs in CaRMS Online. All documents should be assigned to second iteration programs before the beginning of file review. Consult the second iteration timeline for exact dates.
Is there a deadline for submitting and assigning documents?
We strongly recommend you assign all documents by the document assignment milestone to ensure that your application is complete when the online system closes in preparation for file review. While you are able to assign documents after file review opens, it is up to each program to decide if it will consider documents that arrive after file review begins. This information should be included in the program description. CaRMS will notify programs of any documents you assign after file review begins; however, we take no responsibility for the review of documents that are sent in after file review opens. Carefully review the match timelines for information about milestones and deadlines.
Are documents accepted if they are received after the document arrival milestones listed on match timelines?
Any documents received after document arrival milestones are still accepted, but we cannot guarantee that they will be available in your account before file review begins, or that they will be reviewed by programs if available in your account after file review opens.
I have previously participated in a match. Do I need to resubmit my documents?
We do not require documents to be resubmitted unless the applicant has an updated copy. In this case, applicants can upload the new document to their CaRMS Online application. Note that in some cases applicants will need to delete the older version of the document from their application, or the documents department will be required to delete it, before the new version can be uploaded.
I’ve mailed in a document to CaRMS—is that a problem?
CaRMS does not accept mailed documents from applicants. You must upload all documents directly to CaRMS Online.
For more information, including document submission instructions, visit our document submission page.
I received an email from CaRMS indicating that an issue was identified with one of my documents and a new coversheet is required. What do I do?
Follow the instructions in the email to create a new coversheet and send it as a PDF attachment to firstname.lastname@example.org in reply to the original email sent to you.
What documents require notarization?
CaRMS does not accept originals of citizenship documents. Other documents requiring notarization differ from program to program, therefore, we recommend you consult the program descriptions on each of our match pages to find out more about which documents require notarization.
Additionally, transcripts, medical student performance records (MSPRs/dean’s letters) and letters of reference should be originals whenever possible.
Who can notarize or certify my documents?
The Canadian government maintains a list of professionals able to provide certification or notarization of documents. Please contact one of the following professionals to notarize or certify your documents:
- Notary public
- Lawyer, Attorney-at-Law
- Commissioner of Oaths
- Designated official at a Canadian Embassy or Consulate or a designated official at an American, Australian or British Embassy or Consulate or High Commission
- Medical doctor or dentist currently licensed in Canada
- Police officer in Canada: municipal, provincial, or federal (RCMP)
- Justice of the Peace, Judge, Magistrate or Mayor, in Canada
- Professional accountant who is a member of the Association of Practicing Accountants (APA) (United Kingdom); or one of the following professionals: Chartered Accountant (CA), Certified General Accountant (CGA), Certified Management Accountant (CMA), Public Accountant (PA), Registered Public Accountant (RPA)
- Member of Parliament (MP); Member of Provincial Parliament (MPP)(Ontario); Member of National Assembly (MNA)(Quebec); Member of House of Assembly (MHA)(Newfoundland and Labrador); Member of the Legislative Assembly (MLA)(all other provinces and territories)
- Funeral director in Canada
- Pharmacist in Canada
- Veterinarian in Canada
- Professional engineer in Canada
- Municipal clerk at a City Hall in Canada
- Minister of religion in Canada
- Social worker: Bachelor of Social Work (BSW), Master of Social Work (MSW), Doctorate of Social Work (DSW) in Canada
Note: This person cannot be a family member. Most professionals will prepare the document according to their professional practice. In all other cases, the professional must see the original document, make a photocopy of the original document, compare the original document to the photocopy, and print the following on the photocopy: “I certify this to be a true copy of the original document.” The professional must write on the photocopy the name of the original document, the date of certification, his or her name, and his or her official position or title. This person must also sign the photocopy. Applicants should not sign anywhere on the photocopy of the document.
How can I change the name or language of my document?
Applicants must make a request to the documents department to have the name of language of their document changed. When doing so, ensure you send the following information to email@example.com:
- CaRMS ID
- Document name
- Document number
- What needs to be changed
Can I unassign a document that I have assigned to a program?
Yes, you can unassign a document that has been assigned to a program until the closing of the application period. Once file review has opened, you cannot unassign documents.
Can I unassign a document after file review has opened?
After file review has opened you are no longer able unassign a document. You are still able to add additional documents to your application; however, any documents assigned after file review opens are not guaranteed to be reviewed by programs. Refer to program descriptions for more information.
I have recently changed my name. How do I update my application?
Applicants must use their legal name to apply through CaRMS. If an applicant has legally changed their name, they need to upload the documentation showing their change of name as an extra document.
How do I submit a document for translation?
Applicants preparing a bilingual application can request translation of eligible documents from French to English or English to French through CaRMS Online. Once eligible documents are in your CaRMS Online account, you will be able to request translation. Translated documents will be uploaded to your account in CaRMS Online, at which point payment will be requested. The presence of the translated document in your account will be noted on your translation request and document tracking pages.
To learn more about our translation service on our translation services page.
What is CaRMS’ document return policy?
Upon request, you may have all hardcopy documents you provided to CaRMS returned to you. We will only return eligible documents if the medical school to which you were matched does not request the documents for their files. We do not return documents that were uploaded or created online, or those provided by a third party source (i.e., a referee or university). We will also not return letters of reference. Applicants who request document returns but do not have eligible hardcopy documents in their file will not be issued a refund. Please ensure you have documents eligible for return before making a request.
We offer two document return services: regular return and rapid return. If you select regular return your documents are guaranteed to be returned to you within six months of your return request date. If you select rapid return, your documents are guaranteed to be returned to you within one month of your return request date. Please visit the fees page for information on applicable fees. Documents will be returned to the address provided during registration, unless otherwise indicated.
What should letters of reference include?
In order to ensure program directors receive the information they need to evaluate applicants, we recommend letters of reference include:
- A confidentiality statement indicating whether or not the applicant has seen or will receive a copy of the letter;
- The date the letter was written
- The time and duration of the referee’s contact with the applicant
- Assessment of the applicant’s:
- Cognitive skills and knowledge
- Problem solving and patient management skills
- Behaviour and attitudinal skills
- Communication skills and working relationships
- Motivation and punctuality
- Sense of responsibility
- Procedural skills specific to the discipline
- Special qualities and unique contributions
If referees are unable to comment on a specific component of an applicant’s performance in any of the above categories, they should indicate that they have not observed or do not have knowledge of that specific component in their letter.
Do letters of reference have to be confidential?
All letters of reference should remain confidential. As a rule, referees should mention in the body of the letter that it has not been seen by the applicant. When a letter is uploaded into CaRMS Online, the applicant can see that the letter has been processed but cannot view the contents of the letter.
Letters of reference that are sent directly from the applicant to CaRMS may still be processed, specifically when an applicant has immigrated to Canada with the letters in their possession and no longer has the opportunity to have a letter submitted directly by the referee. If you feel this situation may apply to you, you must send a notarized or certified copy of the letter. Original letters of reference submitted to CaRMS will not be returned to applicants.
Can my referee send my letter of reference to CaRMS early?
Yes, applicants can contact referees and request letters of reference before CaRMS Online opens for the match. Applicants can print an early letters of reference coversheet to give to their referee to fill out. The completed form must be submitted to us along with the letter of reference. Once we receive an applicant’s early letter of reference, we will let them know via email.
Does CaRMS check to make sure the specialty is correct on my letter of reference?
CaRMS does notify applicants if the specialty in their letter of reference does not match the specialty stated on the coversheet.
Can reference materials be submitted using an extra documents coversheet?
Reference materials are confidential documents and not visible to applicants. They must be mailed in or uploaded by referees into spots within CaRMS Online created by applicants. These spots are specifically designated for reference materials. If the reference arrives at CaRMS with an extra documents coversheet, it will not be processed and the Documents Centre will contact the applicant.
What information should my citizenship document include?
Notarized and certified documents must include the notarization information or the entirety of the seal and signature of the individual/organization that certified the document.
You may upload a notarized or certified copy of your citizenship document to CaRMS Online in PDF format.
Why did CaRMS send an original citizenship document back to me?
CaRMS does not accept mailed documents from applicants. If original citizenship documents are sent to us, they will be returned at the applicant’s expense.
Can I upload a birth certificate that is not Canadian?
If a program specifies that they require a birth certificate in the Canadian Citizenship requirements section, this means a Canadian birth certificate. Only Canadian citizenship documents should be uploaded to the Canadian Citizenship section.
If the program requires a foreign birth certificate, it should be uploaded in the applicants’ CaRMS Online application using an Other Documents coversheet (found under Extra Documents), or to Certificates and Diplomas in CaRMS Online.
Can I assign two personal letters to a single program?
No, only one personal letter can be assigned to each program.
Can I create a personal letter using an extra documents coversheet?
No. Applicants must create a personal letter within the personal letters section in their CaRMS Online application. This is where programs go to look for applicants’ personal letters and if the letter is not there, it may be missed.
Can I modify a personal letter after it has been assigned to a program?
Yes, you can modify a personal letter after it has been assigned to a program until the closing of the application period. To modify your personal letter, you must first unassign it and then re-assign it after you’ve made the modification. Once file review has opened, you can no longer modify or unassign a personal letter.
What is CaRMS’ institution code and department code for TOEFL?
Our institution code is 8309 and our department code is 00 or 99. If required, you can enter ‘undergraduate’ as the institution type.
Please note: TOEFL mails us your test results and delivery takes between two and four weeks. There is no automated electronic exchange.
What is an MSPR?
The Medical Student Performance Record (MSPR), also known as a dean’s letter, is a document describing your overall performance in medical school. Its contents may be as simple as a confirmation that you did in fact attend your medical school; other MSPRs may include more specific information. The format will vary widely between schools.
Typically, this document:
- Reports on activities during medical school;
- Comments on performance in clinical rotations;
- Gives a recommendation for further medical training;
- Reports on time spent in each specialty or department (hours or weeks).
You must arrange to have the undergraduate office of your medical school send an original copy of your MSPR to CaRMS. All MSPRs received at CaRMS will be treated as confidential and will not be shared with applicants.
Note that not all schools issue MSPRs.
My school does not issue MSPRs. What should I do?
The Medical Student Performance Record (MSPR)/Dean’s letter is a requirement for all programs. However, programs also recognize that this document is not issued by all schools. In cases where an applicant’s school does not issue MSPRs, or if obtaining this document is not feasible, the applicant can compose a letter outlining the situation and the reason(s) the document cannot be included with the application.
Applicants must upload this letter into their application in place of the MSPR.
Information about the applicant’s MSPR can also be mentioned in their personal letter.
Why can’t I create additional spots for my medical school transcript or MSPR?
Applicants can only have one spot for their Medical Student Performance Record (MSPR) and one spot for their medical school transcript (unless they have a bilingual application, in which case they would have one English spot and one French spot for each document) within their application. This is where programs look for applicants’ transcript and MSPR so if they are saved in multiple spots, they may be missed by programs.
If an applicant has attended multiple schools for their medical education, we can create one spot for each institution they attended. Please contact our operations department at firstname.lastname@example.org to have spots for multiple institutions created.
I have submitted my transcript, but my school also uploaded it through the transfer site. Which document takes precedence?
The document from the school always takes precedence, because it is directly from the source.
My document has not yet been scanned, but it was transferred by my school a while ago. Is there a reason why?
There are a couple reasons why your document may not have been scanned.
- It is taking longer than usual because the document was submitted on the document milestone. Most documents are uploaded by schools on the document milestone. When this happens, the Documents Centre will have a larger volume of documents than usual to process. If this is the case, the Documents Centre may require up to five business days to scan your document. If your document has not been scanned after five business days from the date it was received, please contact email@example.com.
- The document has been missed. If the document has not been scanned after five business days, you or your school should contact firstname.lastname@example.org to let us know it has not been scanned to your application. If you contact us before five business days have passed we will reply asking you to contact us again when five business days have passed.
How does the interview process work?
CaRMS posts the interview period dates for all programs in the interview calendar on CaRMS.ca. You will be notified by the program directly if you have been selected for an interview. CaRMS does not set up interviews – program office personnel arrange interviews directly with applicants.
During the interview, neither applicants nor program interviewers must ask the other to make a commitment as to how they intend to rank the other. Doing so is in direct violation of the CaRMS contract.
Invitations to interviews, as well as other notices from programs will likely come via email. You should make sure that your email account is set up to accept emails sent in bulk, as well as those from addresses that are not in your address book.
If you decide not to attend a scheduled interview, you should contact the program in advance to cancel the appointment.
For more information, please consult our interview guidelines.
Formal process for interview complaints
CaRMS will act as an interlocutor to allow applicants to make specific complaints about problems encountered in their interviews. Please visit our interview complaints policy section for details.
Will I ever have to pay for an interview?
There may be travel and accommodation costs associated with an interview that you will have to pay; however, you will never have to pay for the interview itself. If you request an interview via videoconference, the program has the right to charge you for any fees incurred to accommodate the request. If you are asked to pay for an interview, please contact the CaRMS help desk immediately.
How does ranking work?
After your interviews, you must determine the order of preference for the programs you have applied to by ranking them from most preferred to least preferred and excluding any programs that you applied to but do not wish to train at. Programs also rank their desired applicants in order of preference. These lists are called rank order lists (ROLs) and they are the only true determinants of a match outcome.
CaRMS’ online systems make the ranking process simple for you. Your rank order list page is a work area to rank, remove ranks and re-order your program submissions. This page allows you to work on your list development up until you are satisfied with your rankings.
For more information, including ranking tips, visit our ranking page.
What is couples ranking?
CaRMS’ ranking tools allow two applicants (partners) to prepare and submit their rank order lists as a couple. Using this option, each program desired by one partner can be paired with a program desired by the other partner and each of these pairings can be ranked separately. An option is provided for the couple to create and rank pairs of choices in which only one partner may be matched, with the other partner left unmatched. CaRMS does not identify couples to programs. It is entirely up to you as the applicant whether or not you choose to inform programs of your status as a couple in the match.
For more information, please visit our ranking page.
I have applied in multiple streams. How do I rank?
The ranking process remains the same even if you have applied in multiple streams of the same postgraduate program. For example, if you have applied to two different locations under the same discipline. Rank your programs in order of preference from the most preferred to the least preferred. There must be an order to your ranks – no two programs or streams can have the same ranking.
How does the matching process work?
Our Match Algorithm works to match applicants with their best possible outcome where they have been ranked by the program.
Rank order lists (ROLs) are the sole determinants of match outcomes. CaRMS’ matching algorithm compares ROLs submitted by applicants and programs, matching applicants to programs based on both parties’ stated preferences.
The algorithm is applicant-proposing. This means it tries to match the applicant to his or her first choice. If the applicant cannot be matched to their first choice program, the algorithm attempts to place the applicant into the second choice program, and so on, until the applicant obtains a match, or all of the applicant’s choices have been exhausted.
Each applicant’s ROL is traversed downwards from most preferred program to least preferred, until the first program to which the applicant can be matched is reached, or until the applicant’s list of choices is exhausted. Each program accepts applicants upwards on its ROL, continually removing less preferred matches in favour of more preferred applicants, until the program is matched to the most preferred applicants who wish to be matched to the program.