at your program, do residents know the ROL?

[epsilonprodigy]

Just curious if residents have to walk around full of secrets for a few weeks! Obviously this is going to vary by program, but thought it would be interesting to take an informal poll. Don't worry- I/we won't hound any residents about it, obviously.

N=1, but at my school, residents seem to know. (Granted, I haven't specifically asked anyone, because how annoying would that be.) Today, I was chatting with a resident who asked about my ROL, and told him our home program is #1. As we were ending the conversation, he said, oh, I'm sure you'll match SOMEWHERE. Oh, snap! At least this way I get a few weeks to get more used to the idea of ending up at >#2. On the off chance that I misread his comment, getting my #1 will be a pleasant surprise.

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[Doctor4Life1769]

Yes.
We make the decision with faculty.

 

[gutonc]

As with basically every other question you've asked, the answer is, "it depends".

Small programs where a lot of the residents are in on the interview and ranking process? Most or all of them might know.

Large IM program with 40+ residents/yr? The Chiefs (and rising Chiefs) probably know, but unlikely anybody else does.

 

[mvenus929]

I am at a large peds program. Residents make it known who we like, and if we really like someone who rotated with us, they will likely be ranked highly. And if we really, really don't like someone, it is very likely that they will not match with us. That said, we interview like 300 people, so no, we don't know the final rank list.

 

[ThoracicGuy]

Just curious if residents have to walk around full of secrets for a few weeks! Obviously this is going to vary by program, but thought it would be interesting to take an informal poll. Don't worry- I/we won't hound any residents about it, obviously.

N=1, but at my school, residents seem to know. (Granted, I haven't specifically asked anyone, because how annoying would that be.) Today, I was chatting with a resident who asked about my ROL, and told him our home program is #1. As we were ending the conversation, he said, oh, I'm sure you'll match SOMEWHERE. Oh, snap! At least this way I get a few weeks to get more used to the idea of ending up at >#2. On the off chance that I misread his comment, getting my #1 will be a pleasant surprise.

At my program, we had input on who we liked and didn't like, but we NEVER saw the final match list. Likewise, we were never told how far down on the list we went for the match. I suspect most surgery programs are similar as well. I wouldn't read too much into that resident's comments. Besides, at this point it doesn't really matter.

 

[Law2Doc]

The chief residents who participate in the ranking meetings know, but generally wouldn't share that info with the residency at large. If the residents as a group have asked that someone not be ranked at all, they probably can be confident that that request is conveyed. Other than that I wouldn't read too much into a random residents comments.

 

[b-real]

In my residency, we had a day when everyone (residents, faculty, alumni) would gather and rank all applicants. Their mug shots, test scores and select quotes from interview day would be projected, followed by an open discussion. Applicants would get DNR'd for any reason. The overall point of that was that we are going to have to work with you for the next few years, so there has to be a good fit. Apart from a handful of last second changes, the list at the end of the meeting would be the final rank list.

 

[22031 Alum]

At the program where I trained, the administrative chiefs did meet with the PD for a run-through of the rank list. At the two programs I've been at since, no residents have known anything about the rank list, aside from getting DNR power.

 

[epsilonprodigy]

I may regret asking this, but what kind of egregious behavior would prompt a resident to speak up and DNR someone based on roughly 1-3 hours of interaction? A laugh like Steve Urkel? Sleeping with the PD's wife? Pretty hard to do yourself in during such a small time frame.....

 

[b-real]

I may regret asking this, but what kind of egregious behavior would prompt a resident to speak up and DNR someone based on roughly 1-3 hours of interaction? A laugh like Steve Urkel? Sleeping with the PD's wife? Pretty hard to do yourself in during such a small time frame.....

Rude or disrespectful behavior towards anyone, mainly. It does take a lot to get DNR'd. It's easier than you think, however, to get down ranked - but still on the match list - into oblivion. Again, it's a fit thing. If you just don't mesh with the residents/faculty, or annoy someone for whatever reason, you'll slide down the list.

 

[Law2Doc]

I may regret asking this, but what kind of egregious behavior would prompt a resident to speak up and DNR someone based on roughly 1-3 hours of interaction? A laugh like Steve Urkel? Sleeping with the PD's wife? Pretty hard to do yourself in during such a small time frame.....

Sometimes applicants have rotated through the department and the time frame actually isn't all that small. But even when it is, there's always the people that make odd or creepy or sexist or politically incorrect comments at the pre-interview dinner, or see that as an opportunity to get drunk and act unprofessional, or simply come off as really annoying. You'd be surprised. It doesn't happen frequently, but there's almost always one person in every interview cycle that needs to be dropped off the list.

 

[BigTumor]

I may regret asking this, but what kind of egregious behavior would prompt a resident to speak up and DNR someone based on roughly 1-3 hours of interaction? A laugh like Steve Urkel? Sleeping with the PD's wife? Pretty hard to do yourself in during such a small time frame.....

I was standing next to an applicant at an interview dinner who asked the resident we were chatting with which bars were the best ones to go to if you wanted to get "laid." I have heard a few applicants make disparaging remarks about the interview day and/or program in front of the PC. I was actually pretty surprised by how many times that happened.

 

[BigRedBeta]

I may regret asking this, but what kind of egregious behavior would prompt a resident to speak up and DNR someone based on roughly 1-3 hours of interaction? A laugh like Steve Urkel? Sleeping with the PD's wife? Pretty hard to do yourself in during such a small time frame.....

There was one epic applicant who managed to rub everyone the wrong way when I was a third year resident...was a reapplicant having matched previously in a field she wasn't a good fit for, no issue there, but she wouldn't stop talking about how awful a fit it was for her. She was extremely annoying at dinner, constantly interrupted other applicants and the residents. On the interview day, she spoke up during morning report (the first time I'd ever seen an applicant do that) to offer an addition to the differential dx for the case being presented...except that her offering was completely ridiculous for a pediatric patient whose presenting symptoms were fever and refusal to eat. She brought two pairs of shoes - one pair of flats, and one heels - that she kept switching between. She fell asleep at lunch. There was more that happened but those are what stand out a few years removed from the situation.

Medical students who you've interacted with for a month or more can do much to hinder their chances.

As for rank lists: in residency (peds - 26 interns/class), no, never knew the rank list other than the homegrown medical students that we liked got ranked high and that we could kibosh anyone we didn't like.

In fellowship, we sat in on the "grouping session" and so knew which quartile everyone was in, but only the PD, Asst PD and Division Head knew the final list.

 

[mvenus929]

I may regret asking this, but what kind of egregious behavior would prompt a resident to speak up and DNR someone based on roughly 1-3 hours of interaction? A laugh like Steve Urkel? Sleeping with the PD's wife? Pretty hard to do yourself in during such a small time frame.....

I'm not sure if the person I know of actually got DNRed or if he was just ranked so low that he didn't match with us--there are several people on our list like that. But, we made it known that we didn't want him because he actually rotated with us and made very little effort. He was on a rotation with me when our associate PD was the attending on service, and our attending would walk into the resident work room and he'd be looking at car parts on the computer. He'd turn, look at our attending, and then turn back to his computer without making any attempt to hide what he was doing. He didn't show much interest in the patients, and his notes weren't that great. He didn't attempt to look anything up on the patients, and had a bare bones understanding of them (akin to my understanding of the patients that weren't mine). He also didn't really improve when given feedback, which I think was really the nail in the coffin.

 

[Law2Doc]

We pretty much take the tactic that the worst person we would get in the match is probably better than the best person we would get in the SOAP. It's a pretty high bar to DNR someone.

Now that said the approach isn't 100% as we have gotten some really good prelims over the years in the SOAP. But the chance/variance is much higher.

The people you get through SOAP are at least excited to be there. Everyone in SOAP has some red flag or blemish, but the programs SOAPing didn't fill either -- they can sometimes find someone who fell through the cracks for a reason they can look past. Why take someone who rubbed then the wrong way over some unknown who came up short elsewhere potentially for a much less abrasive reason?

 

[Doctor4Life1769]

The people you get through SOAP are at least excited to be there. Everyone in SOAP has some red flag or blemish, but the programs SOAPing didn't fill either -- they can sometimes find someone who fell through the cracks for a reason they can look past. Why take someone who rubbed then the wrong way over some unknown who came up short elsewhere potentially for a much less abrasive reason?

I agree.
The ones who had to SOAP generally don't have a sense of entitlement when they show up.

 

[mvenus929]

We pretty much take the tactic that the worst person we would get in the match is probably better than the best person we would get in the SOAP. It's a pretty high bar to DNR someone.

Now that said the approach isn't 100% as we have gotten some really good prelims over the years in the SOAP. But the chance/variance is much higher.

Our people do too, generally. We have some people that are 'better than the SOAP' on our rank list. Though, as a resident, I don't know who they are. All I know at the end of the day is who we liked, who we didn't like, and who we ended up with.