High stats applicant dropped low on rank list in IM

[Heat45]

Hello, I wanted to post to gain some thoughts from the community as to what happened this past match cycle. I applied IM with pretty high stats (high 250s/mid 260s), multiple pubs, and great letters but only got 7 interviews out of 35 applications, and fell to my sixth rank.

My top 5 ranked programs were “top tier” programs (top 20 on doximity) but I felt like I had the application for those programs. In addition, having only received 7 interviews I feel like there were some things I may have missed as issues on my app. Any thoughts are really appreciated.

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[whoknows2012]

Hello, I wanted to post to gain some thoughts from the community as to what happened this past match cycle. I applied IM with pretty high stats (high 250s/mid 260s), multiple pubs, and great letters but only got 7 interviews out of 35 applications, and fell to my sixth rank.

My top 5 ranked programs were “top tier” programs (top 20 on doximity) but I felt like I had the application for those programs. In addition, having only received 7 interviews I feel like there were some things I may have missed as issues on my app. Any thoughts are really appreciated.

Any possibility there was a red flag? Something that could’ve been in the letter or mspe? That’s really all I can think of based on how you describe your app….

 

[GoSpursGo]

What was your class rank? AOA (if your school does it)? And importantly, were all 35 places you applied to like the top 35 programs?

Ultimately, it doesn't matter--I matched to my 6th place for fellowship, and it wound up being the best place in the world for me. You undoubtedly still are going to a good institution, and you will be able to do whatever you want coming from that institution.

 

[mrbreakfast]

First, it doesn't matter as much as you think it does. Trust me. My rank list would've been absolutely different after vs before residency.

It's hard to say what went wrong, as we're mostly speculating without more details. But:
-For top-tier academic IM, your app is solid, not stellar. It's not like your "numbers" gave you a big edge over the competition.
-If you're coming from the Midwest and applying mostly to coastal high-power programs, your batting average is going to be low. If you're wondering why you only got invites to 20% of your programs, I'm assuming part of that is because you hit some geographic filters. I have no actual evidence of this, but anecdotally I believe applicants have a much better chance at programs they can get to within a couple hours' drive.
-There may have been something in your app. Your letters may have not been as amazing as you thought. No offense, but everyone thinks their letters are great. Your personal statement might have been bland. Who knows, we never will.
-If you matched at your second-to-last choice, you may consider working on your interview skills. But, hard to say, as it sounds like all your interviews were at competitive places.

The simple fact is that many people want to match at "big-name" East/West coast programs, and many people apply based on doximity; those programs have to screen people out, and that may have happened to you. Don't dwell on it, instead focus on the opportunities you do have.

 

[Heat45]

Any possibility there was a red flag? Something that could’ve been in the letter or mspe? That’s really all I can think of based on how you describe your app….

Nothing at all, no red flags throughout school and my deans letter/committee letter had nothing that would’ve taken away.

 

[Heat45]

What was your class rank? AOA (if your school does it)? And importantly, were all 35 places you applied to like the top 35 programs?

Ultimately, it doesn't matter--I matched to my 6th place for fellowship, and it wound up being the best place in the world for me. You undoubtedly still are going to a good institution, and you will be able to do whatever you want coming from that institution.

I was in the top 20% of my class on my deans letter but was not AOA (my school calculates AOA and the Deans letter class rank differently for some reason). I appreciate that and I’m very happy with the program I am going to, just disappointed with expectations that were set for me by mentors and myself. I don’t want to go into fellowship applications down the line and make the same mistakes.

 

[Heat45]

First, it doesn't matter as much as you think it does. Trust me. My rank list would've been absolutely different after vs before residency.

It's hard to say what went wrong, as we're mostly speculating without more details. But:
-For top-tier academic IM, your app is solid, not stellar. It's not like your "numbers" gave you a big edge over the competition.
-If you're coming from the Midwest and applying mostly to coastal high-power programs, your batting average is going to be low. If you're wondering why you only got invites to 20% of your programs, I'm assuming part of that is because you hit some geographic filters. I have no actual evidence of this, but anecdotally I believe applicants have a much better chance at programs they can get to within a couple hours' drive.
-There may have been something in your app. Your letters may have not been as amazing as you thought. No offense, but everyone thinks their letters are great. Your personal statement might have been bland. Who knows, we never will.
-If you matched at your second-to-last choice, you may consider working on your interview skills. But, hard to say, as it sounds like all your interviews were at competitive places.

The simple fact is that many people want to match at "big-name" East/West coast programs, and many people apply based on doximity; those programs have to screen people out, and that may have happened to you. Don't dwell on it, instead focus on the opportunities you do have.

Thanks for the response and I appreciate the honesty. To be frank I don’t think my app is stellar but I was confident with my application such that I would receive interviews (and therefore consideration) at more than 7 of 35 programs, many of which my school has sent students to in the past. Indeed I won’t know what my letters sounded like and that could’ve been where the fault lied however my first 4 ranked programs sent me interviews on their first wave meaning they probably went through my letters.

I agree, it could’ve been the way I interviewed. I was told during the mock interviews I had that it wouldn’t hold be back but I could’ve choked.

 

[NotAProgDirector]

Agreed with the advice you've received here. Looking at your post history, you've mentioned in two threads different details -- in one you mentioned that you had honors in all of your rotations, in the other you had Honors in a few and High Pass in the rest. If the latter is true, then that could be playing a role here. You mention that you were in the top 20%, so this seems like less of a problem.

Agree that there's no real way to know. You could ask your home IM PD for input -- assuming you applied to them, they would see all of your letters etc. If you matched there, then this conv would be difficult and I wouldn't ask at all. If you ranked them 1-5 then they did not rank you highly either -- and honest feedback in that case would be very helpful.

 

[Heat45]

Agreed with the advice you've received here. Looking at your post history, you've mentioned in two threads different details -- in one you mentioned that you had honors in all of your rotations, in the other you had Honors in a few and High Pass in the rest. If the latter is true, then that could be playing a role here. You mention that you were in the top 20%, so this seems like less of a problem.

Agree that there's no real way to know. You could ask your home IM PD for input -- assuming you applied to them, they would see all of your letters etc. If you matched there, then this conv would be difficult and I wouldn't ask at all. If you ranked them 1-5 then they did not rank you highly either -- and honest feedback in that case would be very helpful.

Indeed I honored most of my rotations (including IM) and HP the rest… asking my home PD is a good idea thanks for the suggestions.

 

[operaman]

Other possibilities- lots of people applying from your class. Often programs will limit how many people they interview from the same school. If stronger students from your school applied and got interviews, then that may be part of it.

Letters may not have been as strong as you think. Most letters are generic and forgettable, even for stellar applicants. The best have a couple really good ones though. Someone well known saying you’re the best student they’ve ever met. If yours were all generic strong student letters, that may have held you back.

Geography definitely always a big deal.

Interviewing poorly may have also dropped you a bit. Even if you didn’t choke, you may not have been compelling enough to stand out against candidates with equal or stronger apps.

Quality of your med school. If your school is more middle tier, they may have sent students to top programs but they would have been stronger students. I went to a middle tier school and from my class we sent some students to top programs in tough specialties, but these were our top students, junior AOA, beloved and well known by all. Others who were maybe senior AOA or just missed the cutoff didn’t fare as well.

 

[NotAProgDirector]

Top 20% of your class and not matching IM at your home school, when it's not a tippy top place (hinted in your prior threads), is a sign there's a problem somewhere. Make an appt with the PD. Tell them you're not angry (even if you are), explain that you fell farther on your ROL than you expected, and you want honest feedback about what happened to improve in the future. You may, or may not, get it. I'd probably email them before you meet and explain all of this, so they don't have to "think on their feet". If they say "it was a competitive year" or "normally you would have matched with us but this year we matched higher on our list than usual" or anything similar - that's BS and not helpful. Of course they filled above you -- else you would have matched there. What you need to know is why those other people were above you - or why you were below them.

 

[Osminog]

Congratulations on matching. Performing an autopsy on your residency application seems like an exercise in futility. You can’t change the outcome. You may as well just try to enjoy your time between medical school and residency, and hope to make the most of your three years of training.

 

[DarkBluMage]

What’s the point of stressing about this? You’re officially a doctor, you matched, congrats on that. Why not revel in that rather than worrying about something you can’t change and that honestly doesn’t matter at your stage? It’s like worrying about why you didn’t get into XYZ med school after already getting accepted to another med school. There’s no point in that.

 

[mrbreakfast]

however my first 4 ranked programs sent me interviews on their first wave meaning they probably went through my letters.

I'm not sure what to make of interview timing. You hear all sorts of things about "first-wave interviews," etc, but I'll tell you the program that ended up as my #1 rank offered me an interview the day offers opened and was my second interview of the season; my #2 program was my fourth. The place I ended up matching was my 11th interview. So it's hard for me to say how much that mattered.

Having now sat on the other side of the table, residency interviews are a strange process. I'll tell you that many applicants interview "well," but few truly stand out, either as good or bad. We look for lots of things, including cultural fit and personality. Many places don't look for the X number of best applicants overall, they look for the X number of best fits.

Like others said, this may well all be for the best. No applicant knows how to evaluate programs well - this is obvious for you as well, as you admitted you went off of doximity rankings (a poor metric, though arguably the best applicants have). I'd recommend accepting things as they are and making the best of it. If nothing else, use this as motivation to perform strongly in residency and set yourself up for the fellowship you want.

 

[Slack3r]

What’s the point of stressing about this? You’re officially a doctor, you matched, congrats on that. Why not revel in that rather than worrying about something you can’t change and that honestly doesn’t matter at your stage? It’s like worrying about why you didn’t get into XYZ med school after already getting accepted to another med school. There’s no point in that.

If they’re thinking about fellowship (likely since it’s IM) it may be worth digging into, particularly if poor interview skills could be to blame. I fell to middle of my list during the residency match, which I suspected was from so-so interviewing. Never bothered to look into it, and then ended up falling down my list again for fellowship. It all worked out in the end, but it might’ve made my life a little easier to know where I stood post-residency match.

 

[esob]

At the end of the day, programs that pass you over are less about your worth as an applicant and more about their preference as a program. You can have great stats, but if your program, for example, values students who were tutors during med school, they might pass you over because that is their preference rather than that there was something intrinsically wrong with your application.

Unless you have a strong feeling that "something" was wrong with your application AND you want to correct that issue in preparation for applying to fellowships, there is no real value in perseverating on where you landed on your rank list.

 

[NotAProgDirector]

Reading everyone else's comments, I'm going to agree and temper my prior comment. There's only value in pursuing this if it will help in the future. The best solution might just be to leave it alone. A fellowship app (if you decide to do so) will have all new letters and the weight of your MSPE will be much less.

 

[aldol16]

This really illustrates that stats isn't everything when it comes to these elite programs. Past a certain level, other things start to matter more - who you know, who vouches for you, your research, your extracurriculars, your overall story, etc. Many many people apply with top stats to these programs and they have the luxury of being able to choose people based on those other factors. Think of stats as getting you in the door. The rest of the interview is up to you.

 

[Perilous Pursuit]

Sorry you were disappointed with how the match turned out. Speaking somewhat anecdotally from my own and others’ experiences this year, top tier IM was much more competitive than I had anticipated or expected. Seemed like AOA and school prestige matter more for top IM than almost any other specialty even at the high end, so high board scores, good letters, research, and even a decent interview may not be enough to outweigh the absence of those two factors. I’m not sure why top IM is so brand conscious compared to their competitive specialties but the process definitely humbled me.

 

[mistafab]

GOnna be honest bro. Time to move on.

The program you matched at wanted you. They feel you are a good fit for them. Almost always the people who are PGY2/PGY3 at places they matched at realize that it turned out well for them in the end.