How to rank programs?!?!

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As I go through interviews, I always send out thank you emails and I get a response from a couple of people, but I am not sure how to rank programs.
- Does everyone get told that they will fit in well into that specific program?
- Do people get personalized letters/emails from programs (whether it be chairmen, directors etc) closer to rank time to help sway decisions?
- Do we rank based on if we liked the program or on our chances on getting in?

Any advice would help! Thanks

Do not rank programs based on your likelihood of matching there... It does absolutely nothing for you. Rank programs in the order that you would hope to match. Ranking a program that you are sure to match at lower on your rank list does not hurt your chances of matching there; it only improves your chances of matching at any of the programs that you ranked higher.

I don't believe programs tell each and every candidate that they would fit in well. At the same time, if a program does not say this, it does not mean that they dont think you would be a good fit. The large majority of programs mentioned during interviews last year that they would not be contacting us till the match as they did not want risk a match violation. As I have mentioned in a previous post, I think it is worth telling your #1 program that you are ranking them as such. It can't hurt and in a few programs, such as my home program, it may help break a tie between 2 applicants. Obviously don't go telling multiple programs that you are ranking them #1... Ophtho is a small field and it can come back to bite you in the ass. I personally did not tell any program that I was "ranking them highly" as I felt that was just a euphemism for "I am not ranking you #1"

thank you @doctortom! This really helped!!

https://docs.google.com/viewer?a=v&q...VKPQ1BxYL1meFw

I think the interview season is winding down with most remaining interviews being carried out this week, with a few more next week.

I am currently struggling with my rank list and was wondering if I could get some help. Really, it boils down to being in a stronger program in a smaller city versus being in a program in NYC. However, NYC programs are known for being surgically weak and I get the impression that surgical training is very important during residency since the other didactics you can probably get from a book but surgical skills can only be gained via experience. I have never lived in NYC and have loved it every time I visited. Am not sure if choosing a program for its location is worth it in the long run. The other program is excellent in every way and the residents are very very happy.

Your thoughts are much appreciated!

NRMP or some other site shows the algorithm for the match and how it uses your ranks. I'm too lazy to find it or try to explain it, but it's very clear that the best thing to do is to rank in the order YOU HOPE TO MATCH. Even if you have absolutely no chance at your #1 it's still better to rank your own preferences

I would not choose the program in NYC. The programs there are weak in more ways than just surgically. Most attendings in NY are more worried about their private practices than resident education. And living in NY gets old quickly when you're in debt, are living in a closet, and don't actually have the time to enjoy NYC anyway as a busy resident (and no, ophtho residency will not be easier than medschool).

Originally Posted by Dusn

The programs there are weak in more ways than just surgically. Most attendings in NY are more worried about their private practices than resident education.

This has been my observation as well. I'm sure there are attendings who are truly invested in teaching but they seem few and far between. NYC is such a competitive market for ophthalmology that most attendings seem more preoccupied with making sure their practices stay busy than they are with resident education.

Thanks guys for the input. I have heard about the low surgical numbers and private ophthalmologists. I just can't seem to pass up the opportunity to live in NYC even though I know that might not be the right thing to do. The right thing to do is not exactly synonymous with what I want to do (which is live in NYC!). ARGH, so hard! Anyone who's a resident in NYC on the forum? Can you please share your experiences?

Originally Posted by iloveeyes

Thanks guys for the input. I have heard about the low surgical numbers and private ophthalmologists. The program I have in mind is very strong academically and during the interview, the program director mentioned 110-120 cataract extractions, glaucoma and retina surgeries in the 10-20s, which doesn't sound all that shabby to me. Also, they have an amazing fellowship match, which is what I plan to do eventually. I just can't seem to pass up the opportunity to live in NYC even though I know that might not be the right thing to do. The right thing to do is not exactly synonymous with what I want to do (which is live in NYC!). ARGH, so hard! Anyone who's a resident in NYC on the forum? Can you please share your experiences?

Which specific program in the "smaller city" are you talking about? Or perhaps just tell us which city.

I agree with most of the comments here -- choose the stronger program. This is your lifelong training we are talking about.

The only reason I could foresee wanting to choose a NYC program is if you are single. Yes, the dating life in NYC is pretty good which might (big emphasis on might) be a good reason to choose it over a stronger program.

Iowa, which is in the middle of nowhere unfortunately. However, it is a perennial top 10 residency program and there's no question the strength of the training is top notch.

And yes, I am single and in my late 20s. Would prefer not to die alone in the long run, if possible. Everyone in Iowa seems to be already married, unfortunately.

Los Angeles programs are pretty awesome. And you might find a "match" (e.g. spouse) too!

LOL, I actually didn't apply to West Coast programs but thanks for the heads up!

I think I will be the voice of dissent here and encourage you to rank the NYC program(s) ahead of Iowa if that's where your heart is. I believe it's important to take geography into strong consideration if you think that you will be happier living in the city. Afterall your happiness outside of residency will likely have an positive effect on your performance and productivity during residency. People say it's "only" 3 years of your life, but I personally know of people who ranked with their head and not their heart, and were extremely regretful/disappointed as a result. At the end of the day, you will likely get phenomenal clinical training at any of these places, and I don't think doing 20 less cataracts during residency will make or break your future reputation as a physician.

FWIW, I'm a current applicant going through some of the same issues...and I did not interview at Iowa (but did interview at 3 NYC programs), so I in no way am saying this for my own personal benefit. I've interviewed at several great programs in less desirable/more remote locations that offer fantastic clinical training...but as someone who is not married and has no children, I ultimately felt like I just didn't fit in as well and wouldn't be as happy at these places. And I think that my rank list will reflect this appropriately.

Good luck!

Originally Posted by eye love ewe

...I don't think doing 20 less cataracts during residency will make or break your future reputation as a physician...

I think the minimum graduating from residency should be 150 cataracts.

What are the average NYC numbers?

Originally Posted by iloveeyes

Iowa, which is in the middle of nowhere unfortunately. However, it is a perennial top 10 residency program and there's no question the strength of the training is top notch.

Ouch. Yes, being single in Iowa does not sound so appealing compared to being in NYC. Being a single minority in Iowa sounds even less appealing. I think NYC training has probably been vilified way too much. I am sure it is fine. But NYC Ophthalmology would be better off if they only had 3 or 4 programs instead of whatever it is now. To me, there isn't much difference between doing 150 cataracts and 250 cataracts. I do think there is a big difference from 80 cataracts to 150 cataracts though.

All of these small numbers are being nitpicky. You can easily do 300-500 cataracts your first year of practice if you find the right setting. That is when you really learn cataract surgery.

Does anyone know what NYU's numbers are?

I think the average numbers I have heard in NYC are 80s-110s, not quite your 150. NYEEI has the highest numbers of all the programs. UMDNJ, though not quite in NYC proper, has a ridiculously high number, 180-200 and the residents see about 40-50 patients a day. They don't have fellows and cover the entire state of New Jersey, which explains the busyness. You come out super strong clinically though.

As someone who has been out in practice for a few years, it is somewhat humorous that there is so much emphasis on 120 cataracts vs. 200 cataracts and that a program is considered "ridiculously" busy if you do 200 cases. Yes, it is nicer to have done more than less, but these numbers are miniscule compared to what you will do in the first few years of private practice. I think something important to look for in a program is some breadth of training. For example, it is probably better to give up 30 cataracts if you could do 30 filters or 30 blephs or 30 transplants instead. I think it is also probably a good idea to make sure you are doing all of your surgeries the right way during residency, and are not just operating for the ego boost. Just a thought.

This page from the NRMP explains how to optimize your rank list:
http://www.nrmp.org/res_match/about_res/algorithms.html

I'm assuming our match uses the same algorithm, right?

It won't help you decide which program is right for you, but it explains why it's best to just list your programs in order of preference.