BACKGROUND: Matching to a gastroenterology (GI) fellowship position in Canada is increasingly competitive.OBJECTIVE: To identify factors that determine how residents rank programs across the country, and how program directors rank their applicants.METHODS: Using input from several current GI trainees and former program directors, two separate surveys were developed. An online survey was sent one month after the match to every resident matched to an adult GI program in the 2007 match. A separate online survey was simultaneously sent to all program directors of 14 accredited GI programs in Canada. Two subsequent cohorts (2008 and 2009) of matched residents were surveyed during the annual GI fellow endoscopy course at McMaster University (Hamilton, Ontario).RESULTS: The overall response rate was 64 of 91 (70%) for residents and 11 of 15 (73%) for program directors (one program had codirectors). Using a five-point Likert scale for rating the importance of various factors influencing their decision, residents from three years ranked the following factor as most important: suitable location for spouse/partner/family (median score = 5). The overall least important factor was an opportunity for pediatric elective (median score = 2). Using the same scale, program directors ranked the following factors as most important (median score = 5) in ranking residents to their program: the ability to get along with others, outstanding reference letters, exceptional curriculum vitae and applying to only one specialty.CONCLUSIONS: Several factors important for GI applicants and program directors were identified, as well as a few less-important factors. Based on these results, GI training programs can more effectively market their programs to applicants in the future, and residents applying to GI programs can strengthen their applications in the ever competitive match process.