changing 1st choice program

[ChocolateKiss]

Hello,

Several weeks ago I told my top-choice preliminary year program that it was #1. However, this week my husband learned that he will have to move due to a new job next year.

Our new residence will likely be about an hour away from my old first choice program, so that bumps it down to #3 on my list.

However, I am not sure if I am now "obligated" to rank that program #1 since I told them by email that I was going to do this. I do not want to contact the program and explain the situation since I think that would ruin my chances of getting into that program at all (even though it's not my #1, it's still high on my list).

I know that there are no official rules, but I was wondering what you guys would suggest doing.

Thanks for the help.

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[ResidentMD]

Hello,

Several weeks ago I told my top-choice preliminary year program that it was #1. However, this week my husband learned that he will have to move due to a new job next year.

Our new residence will likely be about an hour away from my old first choice program, so that bumps it down to #3 on my list.

However, I am not sure if I am now "obligated" to rank that program #1 since I told them by email that I was going to do this. I do not want to contact the program and explain the situation since I think that would ruin my chances of getting into that program at all (even though it's not my #1, it's still high on my list).

I know that there are no official rules, but I was wondering what you guys would suggest doing.

Thanks for the help.

You are right - sometimes you cant predict things, and I am sure the program director would understand that.

If I were you, I would not say anything to the first program, and just send an explanatory email after the match to the first program mentioning why what happened, happened (that is, if you dont match with them). These are certain personal issues, intermingling a bit with the professional side of your life - and people would understand. Just my two cents though - would love to hear other opinions.

 

[houstoncfh]

I think the most honorable thing to do would be to man up and explain it on the front end, prior to the match. I think this would effectively ruin your chances of matching at said program, but it's the least shady method to take.

As an aside, if you had a faculty member go to bat for you and call the program, I would think it be absolutely necessary to let the program know prior to the match -- no sense in damaging your school's reputation along with yours.

 

[sam1999]

What is wrong by telling all (or more than 1) programs where you have interviewed that they are your number one choice? After all programs play the same game with you like you will ranked or you will be ranked very high or you will be ranked to match etc.

 

[Pontifex Maximus]

Just let it go. You're not going to be dealing with this program past year 1 anyway, and if you don't match there, who cares? I really doubt these programs hold a grudge for a 1 year prelim. Obviously its better not to be in this setting, but there's nothing that should lock you into ranking them 1. You're only gonna hurt yourself otherwise.

 

[thesauce]

What is wrong by telling all (or more than 1) programs where you have interviewed that they are your number one choice? After all programs play the same game with you like you will ranked or you will be ranked very high or you will be ranked to match etc.

You mean besides sacrificing personal integrity? Nothing.

 

[SouthernSurgeon]

What is wrong by telling all (or more than 1) programs where you have interviewed that they are your number one choice? After all programs play the same game with you like you will ranked or you will be ranked very high or you will be ranked to match etc.

(a) I would echo the above that my biggest issue with it would be sacrificing my own values.

(b) programs are typically very vague with their wording - it is rare for a program to truly say "you're our #1". Applicants often do the same. I personally sent e-mails to my top 4 programs saying how much I liked them and would be happy to be there - but I only sent one "you're my #1" program. I don't see a problem with that (on either the programs' end or the applicants')

 

[sam1999]

Do you guys really think PDs compare notes from all the applicants about who said what or who did not match with them?

 

[Seville]

What is wrong by telling all (or more than 1) programs where you have interviewed that they are your number one choice? After all programs play the same game with you like you will ranked or you will be ranked very high or you will be ranked to match etc.

1. It's totally sketchy and means that you have no problem with lying.

2. From what I have heard from PDs, regional PDs (at least) are often friends and will frequently talk about applicants. They may not do it until after match, or not until they run into each other at a conference, or whatnot, but can you imagine if say PD #1 talked to PD #2 and mentioned "I see you got Sam1999. We really thought we'd get him since he said we were his #1 choice". And on and on.

Maybe it would never happen, maybe it would. I certainly wouldn't want that hit to my reputation though.

 

[SouthernSurgeon]

Do you guys really think PDs compare notes from all the applicants about who said what or who did not match with them?

In general surgery I know the PDs talk to each other and email frequently. To what extent they communicate to each other specifically about individual applicants, I have no idea.

. They may not do it until after match, or not until they run into each other at a conference, or whatnot, but can you imagine if say PD #1 talked to PD #2 and mentioned "I see you got Sam1999. We really thought we'd get him since he said we were his #1 choice".

This is the kind of thing I've heard about - 1 PD saying "oh we really liked so and so and I thought we were gonna get them"

 

[sam1999]

Is it not like price fixing? After all every one wants best candidates and if start talking to each other and compare notes then what is difference?

 

[sam1999]

1. It's totally sketchy and means that you have no problem with lying.

2. From what I have heard from PDs, regional PDs (at least) are often friends and will frequently talk about applicants. They may not do it until after match, or not until they run into each other at a conference, or whatnot, but can you imagine if say PD #1 talked to PD #2 and mentioned "I see you got Sam1999. We really thought we'd get him since he said we were his #1 choice". And on and on.

Maybe it would never happen, maybe it would. I certainly wouldn't want that hit to my reputation though.

It was just a question.

 

[Seville]

It was just a question.

and mine was just an answer.

 

[calvinNhobbes]

You'd be amazed at how small the world of academic medicine is, especially when you break it down by specialty. Moreover, it takes a life time to establish a good reputation, but just one screw up to get a bad one. If you blatantly lie to several programs, odds are it will be known and good luck getting the fellowship or job you want after that when no one will write you a good LOR.

 

[doctorFred]

the PD at my school has told me that not only do PDs talk to each other about candidates, but that when you do something like this, you end up possibly screwing the person in the year behind you applying to that same program. now, it's not like they'll blacklist an entire medical school.. but they can have long memories.

 

[ResidentMD]

the PD at my school has told me that not only do PDs talk to each other about candidates, but that when you do something like this, you end up possibly screwing the person in the year behind you applying to that same program. now, it's not like they'll blacklist an entire medical school.. but they can have long memories.

Let me also add that the topic has been a bit diverted - I think this entire issue started with sam1999's post about what is wrong with telling multiple programs that they are rank 1; which I think has been agreed upon almost by everybody that it is the wrong thing to do.

But the OP has a genuine problem; and assuming that he/she is also doing a prelim year, it may be a competitive specialty where they cannot afford to have programs lose interest in them. So I still stick to my original advice, that say nothing to your former program that was your rank 1, wait for the match result, and if you match into a program that you ranked higher than them, send the PD a genuine apology note explaining what happened, and why you changed the rank order list. That should avoid any bad blood, and also not screw up the candidates from your med school applying in the forthcoming years

 

[ChocolateKiss]

Thanks for the feedback guys. I think I'll go with Resident MD's advice. I do feel guilty about telling a program they are #1 and not ranking them #1, but I guess that's life.

 

[GmailQueen]

Thanks for the feedback guys. I think I'll go with Resident MD's advice. I do feel guilty about telling a program they are #1 and not ranking them #1, but I guess that's life.

Not that I have a better suggestion... but isn't it kind of odd to email a program after the fact when you don't even know whether or not you were ranked to match? I'd be careful how you word it, so it doesn't seem like you're assuming that was the case. For all you'll know, they could have not even ranked you, or not ranked you highly, and getting an email that assumes otherwise might be more off-putting than you not matching there after they had ranked you to match.

 

[ResidentMD]

Not that I have a better suggestion... but isn't it kind of odd to email a program after the fact when you don't even know whether or not you were ranked to match? I'd be careful how you word it, so it doesn't seem like you're assuming that was the case. For all you'll know, they could have not even ranked you, or not ranked you highly, and getting an email that assumes otherwise might be more off-putting than you not matching there after they had ranked you to match.

From what I hear, programs that ranked you can see where you match; I dont think it works the other way though (can applicants see where they were ranked on the program's ROL after March 18th?)

The point is that the OP had told this program that they were his/her #1...and she would just be apologizing for what he/she had said, and justifying that...its just about being honest.

I dont think he/she would be assuming where the program ranked him/her. You are right though, it would have to be worded carefully.

 

[sam1999]

Let me also add that the topic has been a bit diverted - I think this entire issue started with sam1999's post about what is wrong with telling multiple programs that they are rank 1; which I think has been agreed upon almost by everybody that it is the wrong thing to do.

But the OP has a genuine problem; and assuming that he/she is also doing a prelim year, it may be a competitive specialty where they cannot afford to have programs lose interest in them. So I still stick to my original advice, that say nothing to your former program that was your rank 1, wait for the match result, and if you match into a program that you ranked higher than them, send the PD a genuine apology note explaining what happened, and why you changed the rank order list. That should avoid any bad blood, and also not screw up the candidates from your med school applying in the forthcoming years

Way to go ResidentMD. I just asked a question, which I am sure people do it all the time, and you all labeled it wrong to even ask. But your advice is basically same thing but coated with full of sugar and at the same time you are preaching that you are champion of morality. Well done.

 

[thesauce]

Way to go ResidentMD. I just asked a question, which I am sure people do it all the time, and you all labeled it wrong to even ask. But your advice is basically same thing but coated with full of sugar and at the same time you are preaching that you are champion of morality. Well done.

Your question was essentially "what's wrong with being dishonest?"

The OP was not dishonest. She told them the truth of the situation at the time.

Big difference.

 

[thedrjojo]

it also depends what you exactly said in that email... if it was "I will definately be ranking you #1 and nothing will change that" vs "You are my #1" which at the time was true, but if you didn't say that it could not change, they understand these lists are in flux.. there was a reason people have doubts about when to send these emails, because what is too soon and what is too late... you obviously sent yours too soon, but no big deal... I think you should definately say nothing beforehand, you can send something after the fact if you have overwhelming guilt, but besides that, I wouldn't feel obligated to do so.

 

[EaglesPA]

How about you send the email before the match but after the date that programs have to certify their rank list? That way the information will not have any bearing on how this program ranks you - which is how it's supposed to be anyway.

 

[houstoncfh]

That might not be a bad compromise. If you timed it really well, like, say 2 days before rank lists were due, chances would be the programs have already submitted their lists. (I don't think they are as neurotic as we are and change their rank order every 2 or 3 days).

That way, if it REALLY made such a difference, the program could change things, but in all likely would not.

I still maintain the most honorable (though not necessarily most advantageous to you) thing to do would be to essentially tell them upfront, before rank lists are due.

I do think some degree of deception could be interpreted into ResidentMD's suggestion -- even though that's clearly not your intent. (depending on how cynical the PD is feeling that day, I guess).

 

[veenut]

I can see how it would be difficult to contact the program now and tell them you're not ranking them #1 anymore.

Just realize this, though: you're basically screwing over anyone (especially from your school) who ranks that program #1 next year and contacts the program to let them know. When programs start getting lied to about being an applicant's #1 choice, it devalues that type of communication.

 

[SouthernSurgeon]

Just realize this, though: you're basically screwing over anyone (especially from your school) who ranks that program #1 next year and contacts the program to let them know. When programs start getting lied to about being an applicant's #1 choice, it devalues that type of communication.

I don't really get why this would be true for others from your school. It's not like lying is a trait bred by your med school. I would think it just devalues that type of communication in general (and aPD has said here that he takes these things with a grain of salt for exactly that reason).

Now the caveat there would be if you are getting your PD/chair/advisor to make calls on your behalf - if they are putting themselves out there and you lie, it damages their credibility as well (and by extension your school).

 

[ResidentMD]

I can see how it would be difficult to contact the program now and tell them you're not ranking them #1 anymore.

Just realize this, though: you're basically screwing over anyone (especially from your school) who ranks that program #1 next year and contacts the program to let them know. When programs start getting lied to about being an applicant's #1 choice, it devalues that type of communication.

I think though, that being honest after the match though with the PD would not create too much bad blood. Imagine the PD was in the OPs place - what would he/she do? If you are going into Derm/Rads, would you tell your rank "3 - Oh, I'm sorry, but I wont be ranking you #1 though I said so..." They too know its a tough game, and assuming it is a competitive subspecialty, they will have to go only one spot lower on their list. The OP has a genuine reason for changing her rank 1, and I think if he/she explains that to the PD after the match (note: he/she may still match into that program - and then it would be REALLY awkward) - I dont think he/she would be screwing over candidates applying from his/her school next year onwards. It was a genuine issue, and most reasonable PDs would understand it - IMHO.

I agree its not completely ethical - but as I said, if this was IM or Peds, its another story - the OP could be upfront even now. I think in competitive specialties, its really hard to take such a chance.

 

[Law2Doc]

...

I agree its not completely ethical - but as I said, if this was IM or Peds, its another story - the OP could be upfront even now. I think in competitive specialties, its really hard to take such a chance.

I think OPs example is exactly why folks shouldn't be telling places they are their number one, and should be more vague (one of my top choices, toward the top of my list, etc) when communicating. There are rules in place that programs can't seek this info from you and can't telegraph their own rank lists to you precisely to avoid this kind of unethical situation. The match is meant to be when you and the programs find out who liked them best -- this before match dancing only gets you into trouble. As for OPs situation, I think apologizing after the match is the only thing that won't leave OP in a bad situation. It's unethical to tell a place they are the number one choice and then not follow through. But it's career suicide to go back to places before the match and say, "never mind, you aren't my top match anymore". That's a good way not to get ranked at all. It probably won't taint future applicants from your school. The only thing that does this is actually starting residency and being bad at it. It's VERY common for programs not to take future residents from places that put out bad residents in the past. But I doubt your behavior in the match reflects on anyone but you.

As for Sam1999's comment in not grasping the ethical issues involved in lying to programs, I think he needs to realize that, if you can step back a bit from the personal goals of matching well, you have to realize that this is entering a profession, and you have to conduct yourself with some degree of "professionalism". This isn't the "screw everybody over and lie to them so I get what I want" career path. It's a path of hardworking honest caring individuals. You don't start out that career with boldfaced lying. Ethics is a huge component of this field, and if you don't have a moral compass, you probably are in the wrong field.

 

[Doctor Bob]

I think OPs example is exactly why folks shouldn't be telling places they are their number one, and should be more vague (one of my top choices, toward the top of my list, etc) when communicating. There are rules in place that programs can't seek this info from you and can't telegraph their own rank lists to you precisely to avoid this kind of unethical situation. The match is meant to be when you and the programs find out who liked them best -- this before match dancing only gets you into trouble. As for OPs situation, I think apologizing after the match is the only thing that won't leave OP in a bad situation. It's unethical to tell a place they are the number one choice and then not follow through.

I'm not so sure that this is unethical. At the time the OP talked with the program and told them they were the #1 spot, they were. But the situation changed in the interim and they are no longer #1. That isn't an ethical failure, that's life. And so long as the initial comment was made in good faith, changing the rank list to match the new situation is also ethically acceptable.

What would be unethical would be to tell a program that they will be ranked #1 but never having any intent from the start to follow through on that ranking. And that doesn't sound like the situation here.

 

[Doctor Bagel]

I'm not so sure that this is unethical. At the time the OP talked with the program and told them they were the #1 spot, they were. But the situation changed in the interim and they are no longer #1. That isn't an ethical failure, that's life. And so long as the initial comment was made in good faith, changing the rank list to match the new situation is also ethically acceptable.

What would be unethical would be to tell a program that they will be ranked #1 but never having any intent from the start to follow through on that ranking. And that doesn't sound like the situation here.

I agree with this. The op didn't set out to lie or to mislead anyone. She just had some unexpected changes in her life that caused her to rearrange her match list. I think programs understand that things like this can happen and consequently probably don't place a whole lot of weight on these you're #1 messages.

 

[Seville]

There are rules in place that programs can't seek this info from you

That's what I thought. So what do you do if one of the programs you are considering emails you and asks you POINT BLANK, "are you ranking us number 1?" I'm really not sure how one responds to that question (especially if you're not ranking them #1).

 

[Doctor Bagel]

That's what I thought. So what do you do if one of the programs you are considering emails you and asks you POINT BLANK, "are you ranking us number 1?" I'm really not sure how one responds to that question (especially if you're not ranking them #1).

Wow, did that happen to you? That's definitely a violation. Honestly, I wouldn't reply, rank the program low (or not rank) and consider reporting them. If a program is willing to so grossly violate the match rules, I'd suspect they're willing to violate other ACGME rules, so it'd be a signal to me to avoid the place.

 

[Law2Doc]

I'm not so sure that this is unethical. At the time the OP talked with the program and told them they were the #1 spot, they were. But the situation changed in the interim and they are no longer #1. That isn't an ethical failure, that's life. And so long as the initial comment was made in good faith, changing the rank list to match the new situation is also ethically acceptable.

What would be unethical would be to tell a program that they will be ranked #1 but never having any intent from the start to follow through on that ranking. And that doesn't sound like the situation here.

I think yours is a strained argument. That's like saying you asked somebody to marry them, but then during the engagement you met someone you liked better and asked them to marry you instead and don't see anything wrong with that. There is an ethical misstep here, no matter how you try to justify it. Somebody gets burned because they were misled and you didn't follow through on your initial statement. You can't say, hey no big deal minds change and expect everyone to be cool with that. By saying "you are my number one" you are implicitly telling them, "I will rank you number one". That you didn't use those words doesn't mean you didn't lead the PD to that logical conclusion. That's the message you conveyed, (and you did so intentionally as there is no obligation to say anything at all), and if you change course without remedying this misunderstanding it IS an ethical failure, and yes, that's life.

 

[veenut]

That's what I thought. So what do you do if one of the programs you are considering emails you and asks you POINT BLANK, "are you ranking us number 1?" I'm really not sure how one responds to that question (especially if you're not ranking them #1).

I would tell them "definitely". Once they start violating match rules, all bets are off.

 

[SouthernSurgeon]

That's what I thought. So what do you do if one of the programs you are considering emails you and asks you POINT BLANK, "are you ranking us number 1?" I'm really not sure how one responds to that question (especially if you're not ranking them #1).

You have that in writing? I'd consider forwarding it to the NRMP and reporting a match violation. I agree with Dr. Bagel that a program that violates the rules so blatantly now is likely to do so in the future as well.

 

[veenut]

I think yours is a strained argument. That's like saying you asked somebody to marry them, but then during the engagement you met someone you liked better and asked them to marry you instead and don't see anything wrong with that. There is an ethical misstep here, no matter how you try to justify it. Somebody gets burned because they were misled and you didn't follow through on your initial statement. You can't say, hey no big deal minds change and expect everyone to be cool with that. By saying "you are my number one" you are implicitly telling them, "I will rank you number one". That you didn't use those words doesn't mean you didn't lead the PD to that logical conclusion. That's the message you conveyed, (and you did so intentionally as there is no obligation to say anything at all), and if you change course without remedying this misunderstanding it IS an ethical failure, and yes, that's life.

Completely agree with this

 

[Seville]

You have that in writing? I'd consider forwarding it to the NRMP and reporting a match violation. I agree with Dr. Bagel that a program that violates the rules so blatantly now is likely to do so in the future as well.

Yes, I have it in writing. He said though in the email "you don't have to answer this if you don't want to and it won't affect your chances of matching" but I really don't believe that. I feel like if I don't respond, he'll assume I'm not ranking them #1.

I was just thinking about not responding to it until after Wednesday when the ROL are due? Or being non-commital in the response prior to that, you know saying something like "I'm still working through my rank list at this time" (which I am; I've gone back and forth in my rankings over and over again these last few days).

 

[Doctor Bob]

...it IS an ethical failure,

I guess we'll just have to agree to disagree on this one then.

 

[medicomel]

Let this be a lesson for people applying in the next cycle. Always use the phrase "very highly interested" until you're nearly 100% sure.

IMHO, you should only tell one program they're your top choice; otherwise, you're going to be viewed as a liar.

Obviously, as you begin to weigh the pros and cons of each program, your top choice may change. You should refrain from declaring this every time you have a change of heart.

Also, think about fellowships and future jobs opportunities. I know that in my specialty it's a very small world. I intend to apply for fellowships to nearly all the places currently on my ROL.

 

[thesauce]

OP: now that the lists are in...what did you decide to do?

 

[ChocolateKiss]

OP: now that the lists are in...what did you decide to do?

Ranked the program that I really want to go to #1. I'll wait and see what happens with the match before doing anything else. If I match at my #2, I definitely don't want to tell them I didn't rank them #1. I may just let it go no matter what happens and hope no one really cares.

 

[ResidentMD]

Let this be a lesson for people applying in the next cycle. Always use the phrase "very highly interested" until you're nearly 100% sure.

IMHO, you should only tell one program they're your top choice; otherwise, you're going to be viewed as a liar.

Obviously, as you begin to weigh the pros and cons of each program, your top choice may change. You should refrain from declaring this every time you have a change of heart.

Also, think about fellowships and future jobs opportunities. I know that in my specialty it's a very small world. I intend to apply for fellowships to nearly all the places currently on my ROL.

Playing devil's advocate, but dont you think PDs will know that they are not your #1 when you say this? An ideal PD will rank you where he/she wants no matter what they say, but the power trips of some academic PDs are well-discussed on SDN....

 

[BlondeDocteur]

I'm not so sure that this is unethical. At the time the OP talked with the program and told them they were the #1 spot, they were. But the situation changed in the interim and they are no longer #1. That isn't an ethical failure, that's life. And so long as the initial comment was made in good faith, changing the rank list to match the new situation is also ethically acceptable.

What would be unethical would be to tell a program that they will be ranked #1 but never having any intent from the start to follow through on that ranking. And that doesn't sound like the situation here.

The EXACT same thing happened to me. I communicated to my presumptive #1 that I loved them after my interviews were over. Then the deck of cards got dramatically shuffled, and suddenly if I matched at my #1 I would be living 3500 miles away from my spouse.

Circumstances *can* change without any capriciousness on the part of the OP.

 

[Hassler]

The EXACT same thing happened to me. I communicated to my presumptive #1 that I loved them after my interviews were over. Then the deck of cards got dramatically shuffled, and suddenly if I matched at my #1 I would be living 3500 miles away from my spouse.

Circumstances *can* change without any capriciousness on the part of the OP.

I think it is wrong to tell 2 programs #1, even given these "circumstances", because ultimately it gives an unfair advantage to those who do it. I believe this should be a match violation. Sure, things can change dramatically, but to me, sending a #1 letter means that you are sure you want to be there. If you know your husband is applying for a job like the OP, you shouldn't have sent a you are my #1 letter in the first place. It is like if you click the submit button, you shouldn't be allowed to change it, just like once the rank list deadline is passed, you cannot change the list. I sympathize with the OP's situation but the right thing to do is to tell the original #1 program that they are no longer her #1. If you do not know that the program is #1, then don't send the letter by all means.

 

[GMed]

Really? A match violation??? Really???
We don't live in a black and white world. There are shades of gray everywhere and these things happen.

As long as your intention at the time was that they were your number 1, then I don't think ethically you are inclined to do anything else.

 

[DScully]

Really? A match violation??? Really???
We don't live in a black and white world. There are shades of gray everywhere and these things happen.

As long as your intention at the time was that they were your number 1, then I don't think ethically you are inclined to do anything else.

Still, if I were a PD who decided to modify my rank list based on what kind of love letters I got, I'd be very upset if someone ended up matching with me when it was clear that my program wasn't their #1.

With that being said, I am not a PD so it doesn't matter what I think.

 

[gutonc]

Still, if I were a PD who decided to modify my rank list based on what kind of love letters I got, I'd be very upset if someone ended up matching with me when it was clear that my program wasn't their #1.

Any PD who would do this to a significant degree deserves what they get.

 

[Hassler]

Really? A match violation??? Really???
We don't live in a black and white world. There are shades of gray everywhere and these things happen.

As long as your intention at the time was that they were your number 1, then I don't think ethically you are inclined to do anything else.

The thing is, if you are going to tell a program #1, you should be absolutely sure about it. It's the same as when you submit your rank list. Once it's passed the deadline, you shouldn't be allowed to change it, regardless of what happened after the deadline has passed. This is the only way the system can be fair to everyone, because I can totally see people telling 10 programs #1 and then say, well things happened after sending the #1 emails. I am not saying I don't believe the OP's story, but I am concerned about people abusing it.

The alternative solution is the NRMP should set rules saying programs and candidates can't tell each other how they rank (i.e. no rank to match letters, no you are my #1 emails). Wouldn't that make things easier for everyone?

 

[Clemson Doc]

The alternative solution is the NRMP should set rules saying programs and candidates can't tell each other how they rank (i.e. no rank to match letters, no you are my #1 emails). Wouldn't that make things easier for everyone?

On the flip side, when an applicant has told a program that they are #1, and a program has responded enthusiastically in such a way that the applicant knows he will be training there, it greatly lessens the stress for both parties leading up to Match Day. Such mutual respect means a lot in this process.

With that said, I understand that some applicants tell more than one program that they are #1, and some programs tell many applicants that they are "ranked to match" even though some aren't. That's too bad, but I think those situations happen far less than many people think. For the most part, everyone in this process is ethical and professional (at least that's what I tell myself).

 

[DScully]

With that said, I understand that some applicants tell more than one program that they are #1, and some programs tell many applicants that they are "ranked to match" even though some aren't. That's too bad, but I think those situations happen far less than many people think. For the most part, everyone in this process is ethical and professional (at least that's what I tell myself).

I'd like to believe this too. But when I see / know people (i.e. fellow applicants) who tell multiple programs that they are #1, I really want to strangle them to death.

You should not tell any program that they are your #1 unless you are 100% sure and you shouldn't change your mind. If you are just 99.9% sure, then you should NOT tell them they are your #1.

As an applicant, you have no control what programs tell you, but at least you should be responsible for yourself.