Deep into the rank list

[AmoryBlaine]

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A question as match day approaches...

Take your average academic program in a regular specialty like IM, Peds, Anesth etc. How far down will their rank list go? Obvioulsy applicants fall into these categories.

1. People they'd love to have
2. People they'd be glad having
3. People they could live with
4. People they would rather have than have to scramble
5. People they would rather have than end up not filling even after the scramble
6. People they would not have under any circumstances.

My question: how far will a program rank? I know it depends on the competitiveness of the program alot, but how often does a resident show up on day #1 and the PD says to himself, "better than nothing, but not by much..."

I know it's a broad question, just wanted to get a little discussion going on the matter.

 

[amyl]

i don't think you can put anes in the same category as IM or peds as far as competitiveness. I do think that there are times/places/pd's that would rather not have anybody than fill the spot with "someone" but then there are places that would take just about anyone. my home program, for example, if you want into the prelim year or even TY, they will take anyone.... which makes you wonder, right? incidentally, most of the interns are miserable and wished they went elsewhere... but this is my only experience...maybe it is like that in intern-year most places?

 

[Bertelman]

There are, indeed, some programs that would rather not fill than take those under their desired qualifications. Then there are seemingly great programs in a great town, all the right stuff, that dip into the 80's to fill 12 spots. I think there are so many factors, it's hard to determine fully. Who they interviewed that year, the talk amongst friends and these boards. I think mostly it has to do with who they perceive their caliber of residents to be v. where that group of residents perceives they belong. That is, if a program interviews a certain caliber of resident even though it is unlikely that resident will rank them, they're goin' deep.

 

[Adcadet]

I thought I heard that many programs go down somewhere between 3 and 4 times as many slots as they have.

 

[mlw03]

i simply don't understand the logic of a program choosing to not fill rather than take a "sub-par" candidate. perhaps someone can explain the logic of that to me, but as i see it any unfilled spot means unfilled working hours, which will have to be made up by other residents and/or faculty. if you're a FM program with 10 spots and only fill 8 that a lot of work hours that have to be made up. i recognize a "bad" resident isn't ideal, but a bad resident still has to keep people happy to become board eligible so they can't be that bad i figure. but maybe my reasoning is skewed.

the most amusing part of this whole process is the way programs (and applicants) make these life-altering decisions based on such a scant amount of information. my brother is a grad student and when he was applying he'd spend at least 2 days at each place - meals with other students, lots of tours of facilities, etc. these decisions often get made on the basis of 2 hours at a local pub the night before interviews, and then various short interviews over the course of 8 hours. as wiser people have told me, "almost anyone can fake it for a day" - that goes for both programs and applicants alike i'm sure.

 

[marshmallows]

I thought I heard that many programs go down somewhere between 3 and 4 times as many slots as they have.

really. where did u here that? if it's true, i wonder if thats the average for the whole country, or just certain specialties.

 

[mmed]

i simply don't understand the logic of a program choosing to not fill rather than take a "sub-par" candidate. perhaps someone can explain the logic of that to me, but as i see it any unfilled spot means unfilled working hours, which will have to be made up by other residents and/or faculty. if you're a FM program with 10 spots and only fill 8 that a lot of work hours that have to be made up. i recognize a "bad" resident isn't ideal, but a bad resident still has to keep people happy to become board eligible so they can't be that bad i figure. but maybe my reasoning is skewed.

the most amusing part of this whole process is the way programs (and applicants) make these life-altering decisions based on such a scant amount of information. my brother is a grad student and when he was applying he'd spend at least 2 days at each place - meals with other students, lots of tours of facilities, etc. these decisions often get made on the basis of 2 hours at a local pub the night before interviews, and then various short interviews over the course of 8 hours. as wiser people have told me, "almost anyone can fake it for a day" - that goes for both programs and applicants alike i'm sure.

For sure, not to fill rather than take as you said a “sub-par” candidate is 100 times better for any program. Unqualified candidate (many USMLE exam trials with low scores, no reasonable recommendations, away from the field for long time ……etc) will be more problematic to any program. He/she will stuck with step3 forever, will not pass the board exam and the board results of that program will be below national average (just one resident will drop the % significantly), can not manage many situations with patients, families and colleagues. Many weak programs fill with those candidates already on probation or closed. The interview for one or two days or even longer will not sort candidates or give candidates full picture of the program; it is just one thing among many others which will be clear from the application of the candidate and the reputation of the program.

 

[mig26x]

so why offer an interview to someone that you know already has red flags?

 

[orientedtoself]

i saw the four applicants to one spot tossed around on the im forum last year, regarding top im programs. i believe it was confirmed by a pd.

 

[Bertelman]

For sure, not to fill rather than take as you said a “sub-par” candidate is 100 times better for any program. Unqualified candidate (many USMLE exam trials with low scores, no reasonable recommendations, away from the field for long time ……etc) will be more problematic to any program.

When I was referring to certain programs not filling, it wasn't because their candidates were failing step exams. It's probably because their candidate didn't have >220 on Step 1. You'd be surprised at how picky some elite programs can be.

 

[mmed]

so why offer an interview to someone that you know already has red flags?

It depends on how much extent this red flag in the application and usually if a program invites someone with obvious red flag, the program itself has many red flags. Some times if one with red flag, for example pass a test not from 1st trial, there may be something out of his hand and he can explain that and present himself in the interview which may compensate for that and so on. On the other hand, why programs invite an applicant with very competitive application, simply because he/she may perform very badly in interview and will not be ranked at all. If you look at the match statistics you will find more than thousand of active applicants did not rank single program, Why, mostly because no invitations. If you add to those many thousands who scramble you will find a good percent of them without invitations (I assume that) and ranked any program assuming that this will allow them to scramble.

 

[mmed]

When I was referring to certain programs not filling, it wasn't because their candidates were failing step exams. It's probably because their candidate didn't have >220 on Step 1. You'd be surprised at how picky some elite programs can be.

Yes, I agree and usually those programs will not have even minimum score to apply. I was told that one program select all candidates for interviews with 99/99 in both steps but cannot say that in web site. Others have minimum score of 85 from first trial and usually will not invite any one with less than 90

 

[coup de chance]

i don't think you can put anes in the same category as IM or peds as far as competitiveness. I do think that there are times/places/pd's that would rather not have anybody than fill the spot with "someone" but then there are places that would take just about anyone. my home program, for example, if you want into the prelim year or even TY, they will take anyone.... which makes you wonder, right? incidentally, most of the interns are miserable and wished they went elsewhere... but this is my only experience...maybe it is like that in intern-year most places?

I am actually in sore need of prelim medicine programs. Where is this program that you speak of?

 

[dragonfly99]

Why a program might not rank a candidate(s) even if it risks not filling.
Many reasons.
1) if the program really didn't like the candidate and the program is fairly strong, they may think they can find an unmatched candidate, such as a FMG/IMG type, during the Scramble who would be better
2) "stong"/academic program with many sick patients and busy services may fear that if they fill with a clinically and /or academically weak candidate, the person will wash out and/or hurt a patient so therefore it might be better to "not fill" than get that person. There are huge differences among IM programs, for example, in terms of how much ICU time residents have, and how many sick patients are actually in the ICU.
3) once you take a candidate, it may be a lot of trouble to get rid of him/her, although it can definitely be done
4) "snob factor" - some programs may invite people but then if the program perceives the person to be a weak candidate after the interview, they may not want their program's reputation to suffer because of having that person in the program (if he/she doesn't present well/look professional, or if the person seems like someone who would fail board exams, USMLE steps, etc.)