Confessions of a Program Director Making My Program’s Rank List

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

CidHighwind

Full Member
Joined
Jun 12, 2019
Messages
603
Reaction score
859


Saw it on Reddit and thought I would share. The basics of it are that PDs DO care if there is a legit reason for the student to come there/move all the way across the country for them. Programs DO care about post interview communication despite whatever they tell you (seriously, they’ll never admit to it because then EVERYONE would do it) and they even care how generic your thank you sounds. Quite eye opening.

Members don't see this ad.
 
Last edited:
I was raised believing that actions speak louder than words and that’s something I still believe. I have an extraordinarily limited budget and spent quite a lot of time and money to interview at some wonderful programs away from home and I’m hoping that they can accept the time and money spent as evidence that I’m committed and interested. In my opinion post-interview communication introduces yet another form of nebulous gamesmanship to an already stressful and opaque process. I think there is some role for letters of intent to your #1 since that’s a concrete commitment, but if I were a PD thank you notes would not be allowed.
 
  • Like
Reactions: 18 users



Saw it on Reddit and thought I would share. The basics of it are that PDs DO care if there is a legit reason for the student to come there/move all the way across the country for them. Programs DO care about post interview communication despite whatever they tell you (seriously, they’ll never admit to it because then EVERYONE would do it) and they even care how generic your thank you sounds. Quite eye opening.
It takes a real sociopath to make such a thread less than one week before ROL are due (and you know every fourth year either has or hasn’t done said post-IV communication).
 
  • Like
  • Haha
  • Love
Reactions: 11 users
Members don't see this ad :)
1) Did you link the wrong article? This one seems to relate to choosing your LOR writers.

2) I think you're extrapolating advice against post-interview love-letters to something totally different. I consider a "love letter" to be just that, saying "I really love your program and I'm ranking you number 1." That's pretty generic and could be written by anyone. If instead, however, you write, "In addition to the amazing training I would receive at your program, my significant other has a job lined up in your city, and thus I would really love the opportunity to join your program and will rank you number 1." Then you're going to get someone's attention, and PDs are human beings who may try to help applicants out if they're at least competitive for their program.

3) Even if there's an article saying that one PD likes love letters, I would not extrapolate that to other PDs. Nor would I freak out about having sent letters or having not sent them. No matter what you did, it's not the biggest thing that's going to make or break your application.
 
  • Like
Reactions: 3 users



Saw it on Reddit and thought I would share. The basics of it are that PDs DO care if there is a legit reason for the student to come there/move all the way across the country for them. Programs DO care about post interview communication despite whatever they tell you (seriously, they’ll never admit to it because then EVERYONE would do it) and they even care how generic your thank you sounds. Quite eye opening.

I don't think this article at all says what you think it does... This is why the CARS section is important on the MCAT. Also this is the perspective of one PD in Anesthesia. I'm not sure what groundbreaking information you think it contains.
 
  • Like
Reactions: 1 users
I don't think this article at all says what you think it does... This is why the CARS section is important on the MCAT. Also this is the perspective of one PD in Anesthesia. I'm not sure what groundbreaking information you think it contains.

What are you implying? Not every PD feels the same way obviously, but it’s nice to see a PD be honest about how some “fluff” things like communications and med school rank are important to her. I feel like more are like her than we would like to admit/think about, unfortunately.
 
Last edited:
I’m confused what is in this article that makes you think PDs care about post IV communication.
1) Did you link the wrong article? This one seems to relate to choosing your LOR writers.

2) I think you're extrapolating advice against post-interview love-letters to something totally different. I consider a "love letter" to be just that, saying "I really love your program and I'm ranking you number 1." That's pretty generic and could be written by anyone. If instead, however, you write, "In addition to the amazing training I would receive at your program, my significant other has a job lined up in your city, and thus I would really love the opportunity to join your program and will rank you number 1." Then you're going to get someone's attention, and PDs are human beings who may try to help applicants out if they're at least competitive for their program.

3) Even if there's an article saying that one PD likes love letters, I would not extrapolate that to other PDs. Nor would I freak out about having sent letters or having not sent them. No matter what you did, it's not the biggest thing that's going to make or break your application.
I don't think this article at all says what you think it does... This is why the CARS section is important on the MCAT. Also this is the perspective of one PD in Anesthesia. I'm not sure what groundbreaking information you think it contains.

Yeah OP linked the wrong article and i was completely lost what they were talking about

I think it's this article: Post-interview communication: Second looks and “love letters” for residency program recruitment. | Thalamus

Or this: Confessions of a Program Director – Making My Program’s Rank List

Sorry the thread is confusing
 
  • Like
  • Haha
Reactions: 2 users
With Step 1 P/F these types of things are going to grow in importance, like Step 2 will. Like if you actually have a connection that isn't just BS on an application, who you know, etc. Its kinda like how things used to be (from what I've heard from older docs.) I know the current climate is nowhere near what it was back then, but a renewed focus on these types of things instead of random numbers on a sheet and BS like that isn't a terrible thing. It may prevent neurotic people from just shotgunning applications all over the country and clogging the system
 
I’m confused what is in this article that makes you think PDs care about post IV communication.


That’s because I posted the wrong article :laugh: . Here is it from the real article now in the OP:


During our marathon rank-list making sessions, our first draft rank list is based on our post-interview debriefing scoring. Then, we move applicants around based on other “conditions” such as couples matching (Did ENT also like his or her spouse?) and geography (Do you think he or she will really move away from Oregon, when he or she has never lived to another state?), to name two examples.

Then, we review the post-interview communications. Was it personal? Did it seem sincere? What did he mean by “happy to train in Rochester?” How high is “rank highly on my list?” Is that code for they ranked us 5th out of 10 programs? Where is the love? Are we good enough?

“We have SIX commitment emails as of today,” exclaimed our associate program director. Do we rank those applicants in our top 16? If so, we might be able to report that we filled 6/16 in our top 16! We have heard that medical students like to know this information when evaluating programs.

Alternatively, do we confidently rank these SIX applicants somewhere in our top third, hoping that indeed they are being truthful, and that based on 25 years of history in our program, they will indeed match with us. Then, we can save higher spots for other “more coveted” candidates – like from Harvard or Yale (we have heard that medical students like to see that we matched Ivy League schooled applicants, although some of our strongest residents have trained at Caribbean medical schools and other traditionally “lower tiered” schools).”

1) Did you link the wrong article? This one seems to relate to choosing your LOR writers.

Yeah I messed up, it’s corrected now. Once again sorry for the mistake.



I was raised believing that actions speak louder than words and that’s something I still believe. I have an extraordinarily limited budget and spent quite a lot of time and money to interview at some wonderful programs away from home and I’m hoping that they can accept the time and money spent as evidence that I’m committed and interested. In my opinion post-interview communication introduces yet another form of nebulous gamesmanship to an already stressful and opaque process. I think there is some role for letters of intent to your #1 since that’s a concrete commitment, but if I were a PD thank you notes would not be allowed.

You’re not wrong, and some specialties have even banned Thank You cards like plastics has. That said from some of my friends in other industries/careers, thank you cards and post interview communication is VERY important. Residency at the end of the day is a job, so it makes sense why some of that stuff leaks into residency applicantions. That said I agree that that stuff should be banned. IMO “Ranked to match” calls/emails are the worst since all it does is make people that didn’t get them even more neurotic and they’ll know even if they do match at that program that they weren’t “the programs first choice”.
 
Last edited:
So all the links in this thread are to a website selling a service to help medical students match, and are written by "program directors" except they note now they're retired program directors, and god only knows what all that really means. When I did a quick google on Suzie Karan (she wrote the article saying post interview communication plays a big role) it appears she actually started Thalamus and this would be a great blog post to get traffic to her site.

At my program we don't care. So ends my blog post, if anyone wants to send me a $5 bill for this PM me for my paypal :D

Edit - it looks like they actually sell a scheduling service to programs. But still, if they can advertise they have med student traffic they can sell their program for more - it's still a conflict.
 
Last edited:
  • Like
  • Haha
Reactions: 7 users
So all the links in this thread are to a website selling a service to help medical students match, and are written by "program directors" except they note now they're retired program directors, and god only knows what all that really means. When I did a quick google on Suzie Karan (she wrote the article saying post interview communication plays a big role) it appears she actually started Thalamus and this would be a great blog post to get traffic to her site.

At my program we don't care. So ends my blog post, if anyone wants to send me a $5 bill for this PM me for my paypal :D
I 100% agree. I doubt this represents all, or even a significant minority of PD’s opinions.

I remember interviewing at a medical school. After the interview cycle was finished, some lady from the admissions office sent an email to all the applicants saying she was retiring from the med school and starting her own business of helping students get accepted to med school for a price.

There are such sleaze bags in the world, which is why you’re supposed to always announce your potential conflicts of interests when presenting research. This retired PD has a huge conflict on interests she didn’t disclose considering she is one of the founders of Thalamus.
 
  • Like
Reactions: 1 users
I just don't get the angst over this. If it makes you feel better and like you're "doing everything possible," go ahead and send a letter, especially if you have a good reason as outlined above--unless you have a really good reason or can demonstrate a personal connection to the program or area that isn't apparent on your app it probably won't help, but it also probably won't hurt. If figuring out what to say in a way that doesn't seem canned is too intimidating, or you don't feel like it, then don't send one. It's really that simple.
 
  • Like
Reactions: 1 users
Members don't see this ad :)
That’s because I posted the wrong article :laugh: . Here is it from the real article now in the OP:


During our marathon rank-list making sessions, our first draft rank list is based on our post-interview debriefing scoring. Then, we move applicants around based on other “conditions” such as couples matching (Did ENT also like his or her spouse?) and geography (Do you think he or she will really move away from Oregon, when he or she has never lived to another state?), to name two examples.

Then, we review the post-interview communications. Was it personal? Did it seem sincere? What did he mean by “happy to train in Rochester?” How high is “rank highly on my list?” Is that code for they ranked us 5th out of 10 programs? Where is the love? Are we good enough?

“We have SIX commitment emails as of today,” exclaimed our associate program director. Do we rank those applicants in our top 16? If so, we might be able to report that we filled 6/16 in our top 16! We have heard that medical students like to know this information when evaluating programs.

Alternatively, do we confidently rank these SIX applicants somewhere in our top third, hoping that indeed they are being truthful, and that based on 25 years of history in our program, they will indeed match with us. Then, we can save higher spots for other “more coveted” candidates – like from Harvard or Yale (we have heard that medical students like to see that we matched Ivy League schooled applicants, although some of our strongest residents have trained at Caribbean medical schools and other traditionally “lower tiered” schools).”

That's one program. I have also seen a number of people who are involved in the process say that they have their applicants ranked before they even leave the building and don't really move them around that much. There was a study out of some institution (I forget which) that showed that med students are easily swayed by post IV communication, so I think that's the real problem.
 
  • Like
Reactions: 4 users
Two things.

Hedging our bets implies that we are somehow attempting to “game the match.” It implies that we are protecting ourselves against a loss (i.e. not filling) by ranking less qualified applicants higher on our rank list.

In truth, while I have never engaged in that type of manipulation, some programs do."

This isn't how any of this works. Seems like even program directors don't even know how the match process works which is terrifying. Simply put, the way the match works is, you must RANK IN ORDER OF YOUR PREFERENCE. The only way a program can protect themselves against a loss (not filling) is to interview and rank as many applicants as possible. RANK IN THE ORDER OF YOUR PREFERENCE, and do not rank based on your perceived competitiveness...


"As for exclusions? Seasonal dysthymic disorder, for one (it is winter here many months throughout the year…). If I mention that on the interview day and the candidate doesn’t laugh…that is usually an exclusion, too."

Really? That's all it takes to be blacklisted at your program? If they don't laugh at your ****ty joke? I've never heard of seasonal dysthymic disorder. I have heard of seasonal depressive disorder, and I don't know what's funny about that. Maybe people who don't laugh at your joke just think that's what you're talking about?
 
Last edited:
  • Like
Reactions: 10 users
Two things.



This isn't how any of this works. Seems like even program directors don't even know how the match process works which is terrifying. Simply put, the way the match works is, you must RANK IN ORDER OF YOUR PREFERENCE. The only way a program can protect themselves against a loss (not filling) is to interview and rank as many applicants as possible. RANK IN THE ORDER OF YOUR PREFERENCE, and do not rank based on your perceived competitiveness...




Really? That's all it takes to be blacklisted at your program? If they don't laugh at your ****ty joke? I've never heard of seasonal dysthymic disorder. I have heard of seasonal depressive disorder, and I don't know what's funny about that. Maybe people who don't laugh at your joke just think that's what you're talking about?

They sound like they just want a brown-noser tbh. About your first point, she also said that she would rather have someone that wants to be there vs a stud that fell down their list. Although she also said she likes ranking people from Ivy League schools higher. Sounds like she’s all over the place.
 
  • Like
Reactions: 1 users
The person who wrotes this article seems like a ****ty, ****ty person to work for based on the content of the article, like not laughing at a joke, or obsessing over post-interview communication, and trying to 'game' the system.

Obvious COI by being a co-founder of the company.
 
  • Like
Reactions: 12 users
The person who wrotes this article seems like a ****ty, ****ty person to work for based on the content of the article, like not laughing at a joke, or obsessing over post-interview communication, and trying to 'game' the system.

Obvious COI by being a co-founder of the company.

Agreed. I think the scary part is the thought of other PDs being as petty as she is. Imagine being in a residency where you end up on her **** list because you weren’t kissing her butt to her liking?
 
  • Like
Reactions: 3 users
Also, because I'm in a mood - most people don't go from being a PD to just working at a program - I mean career wise it's a huge step back. Based on her writings I wonder if her "retirement" had some freedom counseling involved (as my stellar wife likes to call it).
 
  • Like
Reactions: 1 user
Disclose her crappy program so that future applicants can avoid this cesspool of garbage.

This is poor form. I will never get down and start blowing lies up 10+ diff program buns ever. Medical school application is over. We will all soon be doctors. There’s nothing wrong with letting my #1 my true intention. But it’s def poor integrity to encourage lying.

Have some respect for your applicants, considering that they themselves invest at least $500 for airfare, car transportation, and hotel to interview at each institution.
 
  • Like
Reactions: 1 user
Agreed. I think the scary part is the thought of other PDs being as petty as she is. Imagine being in a residency where you end up on her **** list because you weren’t kissing her butt to her liking?

All the more reason not to be that applicant. I would rather SOAP than be in this program.

3-5 years is a long time and dealing with such leadership will lead to burnout really quick.
 
Disclose her crappy program so that future applicants can avoid this cesspool of garbage.

This is poor form. I will never get down and start blowing lies up 10+ diff program buns ever. Medical school application is over. We will all soon be doctors. There’s nothing wrong with letting my #1 my true intention. But it’s def poor integrity to encourage lying.

Have some respect for your applicants, considering that they themselves invest at least $500 for airfare, car transportation, and hotel to interview at each institution.
You can find the name of her program by searching her name on Google.

Although she is no longer the program director, so that should tell you something about her.
 
Top