Changing ROL after #1 email?

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It's not illegal. There will be no formal retribution and obviously if it happens after rank lists are submitted it's not going to affect your match prospects in any way. Unless you are a heavily courted superstar or applied somewhere with an especially petty PD, no one is going to care by the time you're done with residency (or even done with PGY-1, likely).
 
Applicants, pay attention. We don't care or pay attention to "your #1" because of this. I don't think there has been a single match that I haven't been "lied to" by at least one applicant. This is very common so don't worry. On the other hand, psychiatry is a small world and for those future applicants, avoid this dilemma please. No one will care or call you on this. If you are number X on my list, I assure you number X+1 isn't appreciably worse. We dodge more bullets than we get hit with and no PD wants someone who would rather be somewhere else.
 
Illegal? No. Unethical? Yes. There are many stories (in various specialties) from years past where this resulted in PDs calling the LOR writers and the school and basically saying "the applicant is a liar". Psych is a small field, so I wouldn't want to burn any bridges. Especially if you are hoping to do a fellowship or academic career
 
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