What is wrong with these PDs? They’d rather not fill and SOAP than take good DOs?
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MD & DO co'21 Residency Panic thread
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What is wrong with these PDs? They’d rather not fill and SOAP than take good DOs?
It's not just about the fit of the specialty. If someone is research oriented and sees themselves as a future professor, or maybe getting into the admin side of things at a major center? Training at the brand name center in a big city instead of community program in flyover country might not be just for ego
Plus it's commonly done. Ortho had 1400 MD/DO apps into ortho, and 1000 cross-apps into other fields last cycle.
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Unfortunately yes. Many programs, especially in surgical fields, don't want to take people if they're not AMG MD. They could have all honors and >90% percentile Step scores and they are still screened out.
Yup. I spoke with a former chief who told me if I matched there I’d probably have some of the highest scores of anyone they’ve ever recruited. This year has made it VERY clear to me that name is EVERYTHING in this process. What little bit that is meritocratic will all be gone in a few years. But that’s another thread we’ve all read.
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AnatomyGrey12
Again, I don’t know a single orthopod (and I know quite a few) who would agree with that. You either want to do ortho or you don’t. Being “all in” is a massive thing for ortho.
Dual applying as a back up is common. Ranking back up specialty programs ahead of ortho is not.
You don't feel a touch of dissonance there? Everyone in ortho agrees you need to be "all in" but most people would rather match a backup than reattempt ortho?
Everyone is quick to deny or downplay the problem until it actually affects them personally.
I'm sorry you won't be near your SO. I can't imagine.
Edit: This appears to be happening a lot in rads.
I disagree that committedness is binary. At the end of the day it's the applicant's life, and everyone has a different suffering-payoff tradeoff threshold that isn't any PD's business. The key to surgery residency is just putting your head down and working hard, and you can do that without being 100% committed.
You don't have to love surgery more than life itself to be a good surgeon. That's a common motif and it drives me nuts. You just have to be willing to claim to when someone asks and willing to suffer in residency. Plenty of people fake it until they make it and turn out no worse for the wear. The others go into radiology or anesthesia and there's nothing wrong with that. I'd be unfulfilled as a radiologist but for the lifestyle tradeoff I'd probably be just fine with it if I had been a borderline or overly cautious applicant and it came to that. No way I would have reapplied if I didn't match. Gotta get on with life at some point.
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AnatomyGrey12
I agree with you, the concept I was arguing earlier was when someone said they knew an ortho applicant who was going to rank their anesthesia programs higher than their ortho programs because the ortho invites they got weren’t “as high quality.”
No you don’t have to love surgery more than life, but if you are going to look down on a low tier ortho program invite as not good enough then I would argue you weren’t ever a good fit for ortho (insert any specialty here honestly) to begin with.
Applying to a back up/failing to match and going into a back up aren’t the same as the scenario above.
People are allowed to have different priorities. I’d much rather be in certain places and at my second preferred specialty than in the middle of nowhere at my number one. I think it’s a bit much to imply that means they aren’t right for whatever specialty.
I agree with you in the case that someone is "looking down" on interviews if that's the specific scenario you're talking about. I wouldn't want to work with someone who thinks he's above certain programs, but all that matters is that you can smile and fake it with the people that matter. I don't think someone who would rank ortho and anesthesia programs non-contiguously out of personal preference is inherently unfit for ortho.
Agree with this. It's rare for someone to rank ortho/neuro/etc. programs non-contiguously, as anatomygrey noted, but everyone's bar is set at a different level. If you're doing it because you think you're better than the ortho programs at the bottom of your list, then you deserve not to match (although the order of one's ROL doesn't affect one's chance of matching).
Put yourself in their hypothetical shoes though. Imagine you've known nothing but success thus far, probably some Ivy league college followed by brand name med school. You're surrounded by classmates who overwhelmingly match to the top programs in their fields. Your mentors and role models have all been academics. In fact, the entire environment you've been in for four years is all about research (and you did a productive research gap year), high quality training including tons of rare pathology, and "leading the field." Egos everywhere. You like it, and want that kind of setting for the long term.
Now imagine you're facing a ranklist that forces you to choose between the top anesthesia programs (some of which are nearer to your home area) versus going out to the midwest or south for smaller hospital ortho training. Thinking about the fellowship prospects and overall career trajectory, not as easy a choice as "Ortho or bust"
I don't personally know this guy, I have no idea what his decision making process is, but I think a lot of my classmates would be choosing the top ranking gas programs in this kind of dilemma.
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AnatomyGrey12
It's not something I will ever understand honestly. I think this type of thinking is what leads to people hating their jobs.
Choosing to not rank a place because of truly bad fit or truly terrible training is different than choosing to not consider a program because it isn't "high quality enough." I have serious doubts a Hopkins ortho applicant is deciding between MGH anesthesia and community DO ortho programs in rural Michigan.
To the contrary, I think prioritizing the subject matter over the type of career would make someone hate their job. Someone who wants to be a professor at a major institution would probably not be happy in a community private practice (and vice versa), regardless of the specialties.
You can doubt it all you want, but it's still happening. The average ortho applicant is deep into the top quartile of gas applicants, and our ortho department is notoriously weaker at advocating for applicants than other departments. The difference in competitiveness is huge and he very literally is facing struggling to match anywhere in ortho versus top anesthesia programs.
I cannot even imagine feeling that way. If I'm a general surgery applicant I need to like doing the bread and butter of general surgery not be worried about if I'm in an elite academic institution... Anesthesia is nothing like surgery. That's putting the cart before the horse and it contributes to douchebags ending up in academic medicine instead of training excellent clinicians who happen to also push the field forward.
Edit: I know these people exist because of threads on here and IRL about choosing a specialty where the person can end up at a "top" program but that's a terrible way to pick the medicine you will do the rest of your life lol.
We each have our own experiences but my rotations at the main site vs community satellites have been...different. I can understand someone prioritizing the type of environment first and foremost. And for all the talk of surgery being a drug, there sure are plenty of happy ex-surgical residents in rads and gas programs....
I enjoyed multiple fields so I know it's possible to like two things. We are talking about someone knowingly applying to a very difficult to match specialty ranking a second specialty above some programs in their desired specialty not at the end of the list. This person should have not even applied to these places they are ranking below a backup specialty. That slot could have gone to someone who actually wants to go there. In my opinion, someone chasing academic prestige over the type of physician they want to be is the type of person contributing to what I find distasteful about academic medicine. You don't have to agree, of course.
Okay so I want to clarify... is it okay to tell a program you’re going to rank them #1? Because I’m coming off the high of a solid audition AND solid interview, but we have like 2 months till rank lists. I want to go with a thank you letter in a week or so, then an official LOI like 2 weeks after that saying they’re going to be my top 2. There is one other program I MIGHT rank above them. So this is okay to do? Or is this some kind of violation I’m gonna get in black balled over?
It’s not a violation but I would wait until late January to say “you’re my number 1”. Wait until your interviews are done at least.
My understanding is yes you can send you are my number 1...if they are really your number 1 (especially in a small field because if you say they are your number 1 but you match somewhere else, that means you lie). Then top 10 will be I will rank you highly...AFTER YOU FINISH ALL YOUR INTERVIEWS.
Last year the consensus seemed to be that saying “I will rank you highly” to a program read as “you aren’t my number 1”. Your mileage may vary but I just put things like “I would be thrilled to match with you” in my thank you emails instead.
I will rank you highly is obviously you aren’t my number 1. There can only be 1 number #1 lol. I feel like "I would be thrilled to match with you" sound the same as program saying "I will rank you" or can also mean you will be thrilled to rank them and match there but it can be 10-20?. I will rank you highly mean top 10...or I will even say you are among my top 10...vs the ambiguous "I would be thrilled to match with you”
Well I kind of just want to say straight up “your program will be either #1 or #2 on my rank list” Because that’s the truth.
Is that program willing to rank Carib guys highly because they're MD?
Not sure. It hasn’t matched them historically so I’d guess not. But my conversation with that person never went beyond the program’s evolving DO bias.
Still sucks though. Having a raging attraction for US MDs just because they're MDs is as, if not more, terrible than going top tiers only or bust
I just don’t know if any program especially T10 program like to hear your are my number #2 lol...I rather say you are among my top 3 and let them do the guessing game like they do to us...
Nah. Don’t want to derail into an MD v DO thread. I just wanted to vent/empathize with the other poster.
I’ve read pros/cons of programs and some comments such as “DO caliber” to otherwise solid programs are included in program negatives. Having too many DOs on a regular basis makes a program look bad. Totally get it. Was just bummed that a program I liked decided to be a switch hitter.
Fair enough.
And path. Almost every path resident I know at my home program is an ex-surgery resident, and they are very happy.
Really? Exsurgery into path?
Sorry for your buddy. i don't get programs that don't rank every applicant.
I can understand some will DNR the rare applicant that is inappropriate but thats gotta be < 5 per application season.
Yeah, it's a thing. Cuz path is way cooler than most people realize and also has *much* nicer folks than the avg surgical program. We win over them surgeons when we roll in to do their frozens.
Yes. General surgery and urology.
I spent a few days on surg path. It was awesome.
And, not to ruin the mood, this is why med schools have a serious mental health/suicide problem. Trying to convince students that the match isn't the end all and be all, and that they can have wonderful, successful careers even if they don't go to that place they've always fantasized about to do XYZ, is hard. Let's try to recognize that we've all put in a tremendous amount of work to get where we are, and that regardless of what the next few months bring, there is still a ton that we can contribute/ look forward to in our careers.
I agree with others saying wait until end of January to send a single "you're my #1 email". I think it's fine to send other "I'd be thrilled to match your program emails," but I don't think I'd send a "I'm ranking you highly" or "#2" or "top 3" email because if you match above their program on your list your message was pretty much meaningless to them. Just my personal take though.
You say “I'd be thrilled to match your program emails” is like program says “we will be thrilled if you choose to match here”...both are so ambivalent and means almost nothing. The point of feb is to show programs you have particular interest to these few programs and you want to deliver that message clear to them and at the same time, not to clear so that if they are not your number one, I would say my top 5...🤣 This is my guess...but who knows what the right way really is...🤷♀️
IMO, top 3 or top 5 emails lack any punch because you as an applicant can only match one program (the most likely of which is #1). If I were a PD, I would be hesitant to move an applicant up my list because of that email. I guess it might help if it were a surgical sub since applicants tend to fall down their list more.
I personally would not do the whole "#2" thing. I don't think that would come across well even if it's honest.
Agreed. Not a PD but i feel like i would just think "OK have fun at your #1, Bye Felicia"
I really like this
There is only ONE email you should send towards the end of Jan/early Feb and that is to your #1 program stating YOU ARE MY #1. Any other email to any other program is setting you up for burned bridges and disaster.
This cycle is stressful enough as it is, no need to make it any worse on yourself.
Please don't shoot yourself in the foot and send multiple #1 emails or "you will be ranked highly" emails- as this just translates to "you are not my #1"
This cycle is stressful enough as it is, no need to make it any worse on yourself.
Please don't shoot yourself in the foot and send multiple #1 emails or "you will be ranked highly" emails- as this just translates to "you are not my #1"
What’re peoples thoughts on what to do if your #1 told you not to send a love letter? Do you then send that to your #2 Or you just don’t send one at all? Respect the programs doing no post iv communication per the match guidelines but makes this part a bit confusing.
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A love letter isn't going to make a difference. People just do it to feel like you've done everything you can to match at your top place. Don't stress about it and if you really want to send one to your #1 still, you can. They aren't going to rank you lower because of it, they probably just won't read it. Don't tell your #2 on the rank list that they are your #1 though that is real poor form.
I don't get what's so hard to understand...lol. Why on earth would you send a letter of intent to your #2? If they have you RTM and you end up matching somewhere else you just burned that bridge whether it's in regards to possible future fellowships at the institution or whatever. In all likelihood the #1 letter probably won't even do much, but if you're gonna send it at least don't **** it up.
You're better off sending nothing at all than sending a LOI to your #2
Is the purpose of these #1 emails so they rank you high? How effective are these? I have a clear #1 and I don’t intend on burning any bridges. Just trying to figure out why send them at all
I was told by faculties in my field otherwise. Send #1 and send top 5 or 10 or I will rank you very highly at least. Idk if there is a real right or wrong way to do this tbh. Each program may just take it differently and if you really want to to increase your chance you may just want to take the risk.
^ I recently had a PD at a strong program explicitly tell us on interview day not to send any letters, or even thank-yous. I think it's just inbox clutter
