Consider this when ranking programs in Feb

[impetigo]

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Note: I know this topic has been discussed ad nauseum at SDN, but I'm not sure all the different angles or scenarios have been and thought it might be useful or at least interesting to discuss it some more.

The NRMP sucks for one major reason. Even though they claim that it works in our favor, consider this:

Based on the algorithm NRMP uses, your first choice program (that you rank #1) is your best shot at getting into a program, b/c for any given program, all the students who ranked that program #1 are considered first (in a pool if you will), before students who ranked it #2 (and so forth). The students who rank a program #1 are then given residency spots based on the student rank list of that program. Then, if there are still spaces remaining in the program, they move on to the batch of students who ranked the program #2 on their rank list, and so on.

Theoretically, this seems fine and in our favor. BUT, and this is a big frickin' but, if a program doesn't rank you at all, then your crucial #1 ranking is completely wasted. What I mean, is that the program you have ranked #1 is your best shot, so if you waste it on a program that doesn't rank you at all, then you're jacked b/c with your #2 ranked program, you're considered after ALL of the students who ranked that program #1 on their rank list.

Of course, it might not make a huge deal (like not matching) as long as most of the programs you ranked rank you, but still, it's a big disadvantage for students to whom this happens. And since most students have the least chance (relatively) with the program they will end up ranking #1 if you do what NRMP advises, that means you have the highest chance of not getting ranked by your #1 program and CONSEQUENTLY missing out on your #2 program that perhaps you could've gotten if you had known that your #1 wouldn't even bother to rank you. I don't know how often this screws us, but it seems to be a major (maybe fundamental) flaw in the system that students are not told if a program will rank (or ranked) you.

Feel free to flame away.

 

[Idiopathic]

I am in complete agreement with you.

HOWEVER. Your logic says that the following could happen:

Student A ranks Program #1
Program ranks Student A #200

Student B ranks Program #2 (assuming he doesnt match his #1)
Program ranks Student B #1




Student A would match. Is this true?

 

[ortho2003]

Note: I know this topic has been discussed ad nauseum at SDN, but I'm not sure all the different angles or scenarios have been and thought it might be useful or at least interesting to discuss it some more.

The NRMP sucks for one major reason. Even though they claim that it works in our favor, consider this:

Based on the algorithm NRMP uses, your first choice program (that you rank #1) is your best shot at getting into a program, b/c for any given program, all the students who ranked that program #1 are considered first (in a pool if you will), before students who ranked it #2 (and so forth). The students who rank a program #1 are then given residency spots based on the student rank list of that program. Then, if there are still spaces remaining in the program, they move on to the batch of students who ranked the program #2 on their rank list, and so on.

Theoretically, this seems fine and in our favor. BUT, and this is a big frickin' but, if a program doesn't rank you at all, then your crucial #1 ranking is completely wasted. What I mean, is that the program you have ranked #1 is your best shot, so if you waste it on a program that doesn't rank you at all, then you're jacked b/c with your #2 ranked program, you're considered after ALL of the students who ranked that program #1 on their rank list.

Of course, it might not make a huge deal (like not matching) as long as most of the programs you ranked rank you, but still, it's a big disadvantage for students to whom this happens. And since most students have the least chance (relatively) with the program they will end up ranking #1 if you do what NRMP advises, that means you have the highest chance of not getting ranked by your #1 program and CONSEQUENTLY missing out on your #2 program that perhaps you could've gotten if you had known that your #1 wouldn't even bother to rank you. I don't know how often this screws us, but it seems to be a major (maybe fundamental) flaw in the system that students are not told if a program will rank (or ranked) you.

Feel free to flame away.

this is wrong. If your #1 doesn't rank you your number 2 program will have a provisional match with applicants that ranked them #1. The process then repeats itself and the programs are rematched with any applicants that didn't match with their #1. If yo are ranked higher by the program than an applicant that ranked them #1 and you are available as a 2nd rank, you will be matched with that program and their lowest #1 provisional is dropped. The algorithm is set up so each prgram and each applicant can be matched with the highest ranking off both lists.

 

[Seaglass]

Yeah, that's all wrong. You go to the place on your list that has you ranked highest. For example if you have to go down to your #2 and you are ranked higher by them than all the people who ranked them #1 then someone gets bumped to make a spot for you. There is no magic to the process, no rank is better than any other. The only thing special about the #1 spot on your list is that's the first place the computer will try to find a place for you.

See the Emergency Medicine FAQ for more details.

 

[beriberi]

Feel free to flame away.

You anticipate being chastised for your post. Is that because you know it is blatantly wrong and actively misleading?

There was an excellent post last year explaining in very simple terms how the match works. But the NRMP does a nice job of explaining it on their webpage as well.

If you rank the top twenty programs in the country (NONE of whom interviewed you, and thus did not place you on their rank lists) and then the five crappy programs that you actually interviewed at in positions 21, 22, 23, 24, 25, your chances of matching to those programs are the same as if you rank them 1,2,3,4, and 5.

The algorithm actually accounts for this and initially reorders everyone's rank lists (programs and applicants). If you rank a program that did not rank you, that is deleted from your list and your list is readjusted. If a program ranks a student that did not rank them, then they are deleted from the list and the list is reordered.

The match places you at the highest program on your list that has a place for you ("a place for you" means that you are on their list and that the people ranked higher than you have matched somewhere else). People match all the time at their 10th, 14th selection (look at this page come the end of March and there will be all kinds of howling about how they had no idea they could match that far down).

Don't try to outsmart the algorithm. It is not that smart. Rank everywhere you want to go, in the order you want to go there. Do not rank programs you do not want to go to. Your #1 position is not a special gift that you bestow upon a program.

P.S. There are very few programs that interview students and then do not rank them at all.

 

[beriberi]

HOWEVER. Your logic says that the following could happen:

Student A ranks Program #1
Program ranks Student A #200

Student B ranks Program #2 (assuming he doesnt match his #1)
Program ranks Student B #1




Student A would match. Is this true?

This is not true. The program does not "have a place" for Student A. They have already taken Student B (let's assume they can only take one student).

A program can never take a student lower down on its list if a highly ranked student needs a spot.

If Pablo didn't match at 1,2,3, and 4, but is very highly ranked at General Hospital (number 5), he will match there, even if Suzy, Ahmad, Leslie and Francios all ranked it number 1 but are lower on the program's rank list. (The program takes Pablo and then doesn't "have a space" for them).

The match sucks. The algorithm has very little to do with that.

 

[margaritaboy]

There is always a lot of confusion over how the match algorithm works. Try this link for clarification:

http://www.nrmp.org/res_match/about_res/algorithms.html

 

[stormjen]

This is not true. The program does not "have a place" for Student A. They have already taken Student B (let's assume they can only take one student).

A program can never take a student lower down on its list if a highly ranked student needs a spot.

If Pablo didn't match at 1,2,3, and 4, but is very highly ranked at General Hospital (number 5), he will match there, even if Suzy, Ahmad, Leslie and Francios all ranked it number 1 but are lower on the program's rank list. (The program takes Pablo and then doesn't "have a space" for them).

The match sucks. The algorithm has very little to do with that.

Your explanation seems to imply that the process is weighted more towards the program. Unless Student B's #1 program didn't rank him at all, thus causing his #2 program to become his #1, then Student A should get the spot, regardless of how high Student B was ranked by the program.

I haven't read the NRMP's explanation in a while though, so I guess I'll need to go do that now.

 

[Seaglass]

Student B gets the spot (because in the example he was not ranked by his #1 program) and bumps Student A from the spot. If you are ranked higher by a program and that is the first match the computer will make for you then you will bump someone lower on that program's list off. Visit the NRMP site, it is fairly well explained there. Bottom line - rank them in the order you prefer them, period. You cannot game the system.

 

[OldManDave]

Not to be a pain, but I would suggest to you all to be selective in choosing your battles...some are worth the blood, sweat & tears & other simply are not. No, the match is not perfect, but it sure as hell beat the non-system that preceded it. Also, there are folks hard at work to either rid us of the match or to overhaul it...but those will take time.

For those of you already in med school, esp if you're in your last year or two, it is highly unlikely to change before you go through it. Therefore, in lieu of wasting your valuable time & resources "pissing into a fan", I would kindly suggest that you redirect these elements into maximizing the quality of your application & polishing your interview skills. These are things that you have much more direct control over & your efforts will potentially yield much bang for your buck.

After all that is said & done & you still have some fight left in you - become an activist for your cause (overhauling or doiing away w/ the match). Being an activist can be an immensely satisfying adjunct to your career not to mention massively beneficial to the profession as a whole. However, if you don't land the residency slot you want/need - will all that work in med school have gone to waste?

It's all about priorities...

 

[fourthyearmed]

The match WILL work in your favor. If any of you were in a sorority or fraternity, the residency match works the same way as matching for the Greek system does. The whole system actually makes perfect sense and there is no way to "beat the system". You rank your choices in order and you end up at the highest program on your list that will take you. Period. Just keep your fingers crossed they like you! 🙂

 

[supercut]

It seems highly unlikely to me that a program would fail to rank at all someone who they interviewed. Programs are just as worried about filling all of their slots as we are about matching. So unless you demostrate yourself to be a total jerk who can't get along with people for the brief time you are there for interview, chances are you will make it onto the programs' rank list (many of the programs will even say that they'd be happy to have any of the folks there for interview in the program...and that the day is primarily for you to assess how well you think you'd fit in there)

 

[Gut Shot]

It seems highly unlikely to me that a program would fail to rank at all someone who they interviewed. Programs are just as worried about filling all of their slots as we are about matching. So unless you demostrate yourself to be a total jerk who can't get along with people for the brief time you are there for interview, chances are you will make it onto the programs' rank list (many of the programs will even say that they'd be happy to have any of the folks there for interview in the program...and that the day is primarily for you to assess how well you think you'd fit in there)

One of my good friends recently interviewed at UNC for peds. She was informed that they interview 700 candidates each year and rank 125. Don't ask me how they came up with those numbers.

 

[sohsie]

Student B gets the spot (because in the example he was not ranked by his #1 program) and bumps Student A from the spot. If you are ranked higher by a program and that is the first match the computer will make for you then you will bump someone lower on that program's list off. Visit the NRMP site, it is fairly well explained there. Bottom line - rank them in the order you prefer them, period. You cannot game the system.

Dear Seaglass,
Completely off topic, but did you switch around your signature quote on purpose. The quote (from Barry Goldwater at the 1964 Republican convention) goes:
I would remind you that extremism in the defense of liberty is no vice! And let me remind you also that moderation in the pursuit of justice is no virtue!
http://en.wikiquote.org/wiki/Barry_Goldwater
Your quote has extremism and moderation switched around.

 

[Seaglass]

Yes, yes it does.

 

[sohsie]

Yes, yes it does.

OK, Im glad you noticed too. The question is whether or not you did it on purpose?

 

[jmattwilson]

Your explanation seems to imply that the process is weighted more towards the program. Unless Student B's #1 program didn't rank him at all, thus causing his #2 program to become his #1, then Student A should get the spot, regardless of how high Student B was ranked by the program.

I haven't read the NRMP's explanation in a while though, so I guess I'll need to go do that now.

Agree with Beriberi.
You are forgetting those students the program ranked 2-199 what if they ranked the program 1st, 2cnd, or even 10th and were not ranked by their choices above this program. They get the spot and Student B gets the shaft. Ok say his number 2 program thinks he hangs the moon and ranks him first. He goes to program choice number 2 as number 1 is certainly full having 199 candidates ranked above him.

 

[pez head]

one pd told me that they'd let me know in january or february if they were going to rank me or not. no other programs/pds have said anything like that. what's up with that? i don't have a problem with it and i think it'll help me arrange my priorities, but is it standard practice?

 

[beriberi]

one pd told me that they'd let me know in january or february if they were going to rank me or not. no other programs/pds have said anything like that. what's up with that? i don't have a problem with it and i think it'll help me arrange my priorities, but is it standard practice?

How could it help you arrange your priorities? Whether they rank you or not has nothing to do with where they should be on your rank list. (Whether they rank you high just because they say they do is a whole other topic).

It should not impact your decision at all. If you don't know why, you need to read the nrmp's explanation of the algorithm.

 

[MrPink]

Read the NRMP web site. Rank where you want to go in order of preference. Not that difficult.