Cold Feet

[Pomacentridae]

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I am going to be starting as an intern this summer at a program that was not my number 1 choice. I am feeling uneasy because I made the mistake of ranking this program in a location I've never lived in before higher than the location that is closer to my family and where I have a very close friend. I received multiple love letters from the program that is closer to my family and where my friend lives. However, I stupidly ignored these and ranked the program one spot lower than the program I matched to. At this point I think that in terms of training both programs are of equivalent quality. Let's call the program I ranked lower, program A and the one I matched to, program B. I really liked the PD at A as they seemed very welcoming and supportive. It was patently obvious that program A really supports its residents and has a family setting type of environment. I honestly don't have anything negative to say about the PD at program B and B's PD may be just as supportive. I did not feel as comfortable with the residents at program B but neither did I feel that there was anything egregiously wrong either. It seems that residents at B are worked harder in any case and may at times violate duty hour rules.

Both the locations for A and B are not highly desirable on a national scale but even so B has a significantly higher cost of living than A. I think this can be attributed to the great schools and family environment available at B's location. I'm single and don't have kids so this doesn't really matter to me. The salary at B is higher to somewhat compensate but even so my money would go farther in A's location.

I suppose that in retrospect I am feeling guilty for not ranking program A one spot higher as the locations and quality of the programs are more or less equivalent. At A I was sought after(evidenced by love letters), would feel more comfortable(only based on an interview day though), would be closer to family and friends, and would have a lower cost of living. I think what makes me most feel guilty is the fact that I brashly ranked A one spot lower despite receiving strong interest from them and knowing that I would be near family and a very good friend. I think I only ranked it lower because I was reminded of the growing pains I had during high school in a nearby area. Obviously residency is nothing like high school though. I know that nothing can be changed now so how do i get over these feelings and come to grips with the fact that program B where I matched is most likely also a good fit?

 

[Promethean]

Accept that nothing can be changed now and suck it up.

Consider how much more awful it would be to have not matched anywhere. No, really, try to let it sink in that you don't know that program A would have matched you at all, even if you had ranked it higher. You are thinking that the grass would maybe have been greener there, but love letters not withstanding, it is entirely possible that the program that took you was the only one that was going to, or at least, the only one where others wouldn't have beaten you out for the seats.

The name of this game is "Love the one you are with." The time for ranking was over a long time ago. You laid your bets, rolled the dice, and got a seat. Be happy.

 

[ProfMD]

Love letters from programs should not factor into your decision. You should base your rank list only on your opinion of the programs, not on what you think the programs may think of you. You have no idea where you were on their rank list.

Thant being said, when you made your rank list there was some reason you put B ahead of A. Try and remember those reasons. Also, remember that you will be trained in your speciality of choice. If that fails you, just remember there is nothing you can do about it now anyway.

Pre-residency jitters are normal. These too shall pass.

 

[rokshana]

Done deal at this point...if you are somehow think thAt the "love" letters are enough for you to call up the pdandsay hey! I made a mistake and I really want to be at your program...it's not, the pd has moved on...

You are just going to make yourself unhappy if you keep thinking that...maybe once you are finished they may live you enough to hire you.

 

[BigRedBeta]

One of the most unique things about residency is that it's a rare chance to move someplace new and know it won't last forever. You can live anywhere for 3-5 years (I'm guessing that with the love letters you weren't matching into neurosurgery to get stuck for 7 years in one spot). There's a deadline attached to that residency contract and then you get the opportunity to move on to the next location, one that hopefully is more fulfilling.

Embrace this as an opportunity to see some place new, there's plenty to explore in every corner of this country. Even if it doesn't seem all that great at the moment, you'd be surprised how well you can manage if you just "fake it til you make it". I'm not saying you need to delude yourself, but framing this as a positive time to grow as a professional and as a person can help you avoid the self-fulfilling prophecy of negativity.

 

[drcrispmd]

Congrats on matching! Moving to a new location can be fun. Try to keep a positive attitude and make the most of living in that location. Move early to get to know the area before residency begins. It is only for a few years. Having regrets will make your residency years miserable. Also your fellow residents will likely not want to hang around someone who is always talking about the other program or wishing they lived somewhere else. Trust me, it gets really old hearing about it. Positive attitude can go a long way.


Sent from my iPhone using SDN mobile app

 

[J ROD]

All great advice.......I rolled the dice too and ranked lower than I thought I would too.

But, I have moved to my new locale and actually like it very much and very happy I matched here now.

Make the best out of it since you are going to be in it either way.

 

[HooliganSnail]

The whole ranking system is kinda messed up to begin with.

We could have a long discussion regarding how it is kinda like a cartel, and how it's is ridiculous that you can't negotiate a contract, and that you are stuck somewhere based on a random computer algorithm, and that we treat professionals who spend years and years of their lives dedicated to a certain skill like they are commodities to be traded on the stock market, or how it really does violate anti-trust laws, or how the hospital has you by the balls, because you need to finish a residency or you are essentially unemployable........and all of that is true

But, that is just the messed up ass backwards system we work in.

Once you match, you match. You can transfer next year, but you are locked in for at least one year.

Sorry

 

[Perrotfish]

or how it really does violate anti-trust laws,

To be fair, it doesn't violate anti-trust laws. They wrote an exception to the anti-trust laws for Residencies.

It goes against our country's values, but not actually our laws.

 

[ProfMD]

The whole ranking system is kinda messed up to begin with.

We could have a long discussion regarding how it is kinda like a cartel, and how it's is ridiculous that you can't negotiate a contract, and that you are stuck somewhere based on a random computer algorithm, and that we treat professionals who spend years and years of their lives dedicated to a certain skill like they are commodities to be traded on the stock market, or how it really does violate anti-trust laws, or how the hospital has you by the balls, because you need to finish a residency or you are essentially unemployable........and all of that is true

But, that is just the messed up ass backwards system we work in.

Once you match, you match. You can transfer next year, but you are locked in for at least one year.

Sorry

I'm curious - what system would you propose to replace the match? I'm not saying it is perfect, but how would you recommend filling 27,000 training positions every spring?

Pre-match, it worked like any other job search. Apply, then hospitals make offers, applicants accept or reject offers. Problem was, you had hospitals offering positions the waiting to get responses before offering positions to lower tiered applicants. Meanwhile, who had applicants holding on to offers, wondering if they should take the one in hand or hold out for a higher choice - meanwhile preventing hospitals from offering the spot to someone else. If the hospital set a time frame for response then the applicant would have to decide to accept the offer or hold out for a better one and risk getting no job.

People were not satisfied and the match was born.

 

[Perrotfish]

I'm curious - what system would you propose to replace the match? I'm not saying it is perfect, but how would you recommend filling 27,000 training positions every spring?

Pre-match, it worked like any other job search. Apply, then hospitals make offers, applicants accept or reject offers. Problem was, you had hospitals offering positions the waiting to get responses before offering positions to lower tiered applicants. Meanwhile, who had applicants holding on to offers, wondering if they should take the one in hand or hold out for a higher choice - meanwhile preventing hospitals from offering the spot to someone else. If the hospital set a time frame for response then the applicant would have to decide to accept the offer or hold out for a better one and risk getting no job.

People were not satisfied and the match was born.

If the system is going to allow hospitals to collude to keep trainees who quit/are fired from being rehired by any other hospital, and if the system is going to force even those rare trainees who are rehired to repeat most or all of the training they completed under their last employer, then the match is a necessary protection for trainees.

If you got rid of those insane rules, which apply to no other industry, then you could get rid of the match as well and allow people to organically find jobs just like every other new grad does.

 

[ProfMD]

If the system is going to allow hospitals to collude to keep trainees who quit/are fired from being rehired by any other hospital, and if the system is going to force even those rare trainees who are rehired to repeat most or all of the training they completed under their last employer, then the match is a necessary protection for trainees.

If you got rid of those insane rules, which apply to no other industry, then you could get rid of the match as well and allow people to organically find jobs just like every other new grad does.

I have worked in programs that both hired residents who started elsewhere and that fired residents who subsequently found positions elsewhere. Other than the usual concerns of wanting to know why someone was fired, there were no "rules" or "collusion" between the programs. Also, programs do given credit for prior residency experience, as long as the requirements for that particular speciality, as set by that speciality's board, are met.

And, as I explained, the "organic" method is what used to be done. The people involved at the time felt that it didn't work. That's why we have the match - to increase the efficiency of placing tens of thousands of applicants in a similar number of spots every spring year after year.

 

[Law2Doc]

Having come from a field with no match for initial jobs, I would say a much larger percentage of people end up with what they wanted or pretty close to it through the match. Sure there are a number of people that would do better with a less algorithmic system. But not the kind of numbers that end up with one of their top choices in the match. Far more graduates in other professional fields end up in protracted job searches to find things not as desirable as that to which most of us get matched into. It's actually a very helpful system, from the perspective of someone who has had to unearth jobs the old fashioned way in a prior career.

 

[j4pac]

It's better to go to a program that wants you than one that doesn't. You matched where you are best fit to attend. Leave it at that.

 

[MediCane2006]

One of the most unique things about residency is that it's a rare chance to move someplace new and know it won't last forever. You can live anywhere for 3-5 years (I'm guessing that with the love letters you weren't matching into neurosurgery to get stuck for 7 years in one spot). There's a deadline attached to that residency contract and then you get the opportunity to move on to the next location, one that hopefully is more fulfilling.

Embrace this as an opportunity to see some place new, there's plenty to explore in every corner of this country. Even if it doesn't seem all that great at the moment, you'd be surprised how well you can manage if you just "fake it til you make it". I'm not saying you need to delude yourself, but framing this as a positive time to grow as a professional and as a person can help you avoid the self-fulfilling prophecy of negativity.

This is an outstanding point. I have gotten a chance to explore areas of the country I never would have moved to voluntarily. Actually, the city that I fell in love with (and in) and will be moving to for a permanent job, was one that I would have NEVER considered otherwise. Look at this as a positive and remember - the time goes by quick.

 

[SXMMD]

It's better to go to a program that wants you than one that doesn't. You matched where you are best fit to attend. Leave it at that.

I think that's giving a little too much credit to programs. More like "it's better to go to a program that will tolerate your existence than no program at all" because lets face it, not all programs are ecstatic at receiving the applicant ranked 85, but they do need to fill the spot... having said that, a spot is a spot, take it and run. Training is short, life is long, don't waste the opportunity.

and my solution to cold feet usually involves warm socks, food for thought.

 

[Pomacentridae]

It's better to go to a program that wants you than one that doesn't. You matched where you are best fit to attend. Leave it at that.

I ranked the program I matched to higher than the program that was closer to my family and friends. The regret has been eating away at me since the program closer to home was also the one that sent me letters and emails of interest. I loved the PD there and really do believe that I would have been a better fit at that program . How do I get over these massive feelings of regret, sadness, and anxiety?

 

[Raryn]

I ranked the program I matched to higher than the program that was closer to my family and friends. The regret has been eating away at me since the program closer to home was also the one that sent me letters and emails of interest. I loved the PD there and really do believe that I would have been a better fit at that program . How do I get over these massive feelings of regret, sadness, and anxiety?

Start work. Chances are, after a few weeks of nose to the grind stone building camaraderie with your cohort, you'll wonder why you thought it was such a big deal.

 

[ProfMD]

I ranked the program I matched to higher than the program that was closer to my family and friends. The regret has been eating away at me since the program closer to home was also the one that sent me letters and emails of interest. I loved the PD there and really do believe that I would have been a better fit at that program . How do I get over these massive feelings of regret, sadness, and anxiety?

Buyers' remorse is common. Look at my post above - there must have been some reason you ranked the place you ended up higher than the other place - what were those reasons?

Also, don't read too much into "love letters." Receiving them does not mean that you would have been high enough to rank there.