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I just ran across this paragraph on NRMP policy for Programs...
http://www.nrmp.org/res_match/special_part/inst_officials/match_results.html
This should answer the question about why can't one just tell every program they am ranking them #1. Because the interview committee shall be able to see which program you actually matched in to, and it may jeopardize future fellowship chances, etc...On the Monday after Match Week, institutional officials and program directors can view their Match Results by Ranked Applicant in the R3 System. Applicants are listed in the order of the program's rank order list. Displayed next to each applicant's name is the applicant's match status: the program to which the applicant matched, "unmatched," "withdrew" or "no ROL." The report helps program directors evaluate their programs. The policy of confidentiality, however, restricts the NRMP from releasing specific information about the ranking of programs by individual applicants.
http://www.nrmp.org/res_match/special_part/inst_officials/match_results.html