Devastated with match results

[smartsandwich]

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Hi Everyone
I need some advice. I matched at my 2nd to last program on my rank list. I am from a small medical school, and was hoping to get into a larger academic OB/GYN program, but matched at my home institution, which is a small program.
I want to pursue fellowship, and this program's emphasis is on creating generalists and doesn't have a great track record of getting people into fellowships.
I had great recommendation letters/dean's letter and Step 1 in high 220's and Step 2 low 240's. I had extracurricular activities but no research.
I applied to a good mix of midsize university and community programs, but didn't match at any of those, despite getting good feedback.

I definitely want to leave my program and want to know the best way to approach the PD, without stepping on any toes.

What are my options? Should I reenter the match as a PGY-1 or look for a PGY-2 position for 2014?

Thanks in advance.

 

[anonperson]

Hi Everyone
I need some advice. I matched at my 2nd to last program on my rank list. I am from a small medical school, and was hoping to get into a larger academic OB/GYN program, but matched at my home institution, which is a small program.
I want to pursue fellowship, and this program's emphasis is on creating generalists and doesn't have a great track record of getting people into fellowships.
I had great recommendation letters/dean's letter and Step 1 in high 220's and Step 2 low 240's. I had extracurricular activities but no research.
I applied to a good mix of midsize university and community programs, but didn't match at any of those, despite getting good feedback.

I definitely want to leave my program and want to know the best way to approach the PD, without stepping on any toes.

What are my options? Should I reenter the match as a PGY-1 or look for a PGY-2 position for 2014?

Thanks in advance.

I'm a PGY3 in OB who was in a similar situation as yourself.

Reentering the match is not the greatest option to be honest. You'd be damaged goods and PDs wouldn't trust you the second time around.

If you are dead set on leaving, your best bet would be to complete your PGY1 year and potentially starting a PGY2 year elsewhere. The CREOG Clearinghouse lists open positions. OB GYN has a relatively high attrition rate and openings do occur.

What fellowship are you interested in specifically? MFM, REI, Gyn Onc, or Urogyn?

Your best best bet would be to stick with your current program (especially if it is a good training environment), do well on your CREOGs, do some clinical research in your fellowship area of interest, and potentially do an away rotation during your third year and apply for fellowship.

I matched near the bottom of my list in a community program in a city most people have never heard of. I was contemplating leaving but gladly didn't. The program has trained me into being a good doctor and has supported my fellowship endeavors without hesitation. I'm in the middle of the application process for fellowship and am getting a good number of interviews from well known programs.

Love the one you got.

 

[cabinbuilder]

Hi Everyone
I need some advice. I matched at my 2nd to last program on my rank list. I am from a small medical school, and was hoping to get into a larger academic OB/GYN program, but matched at my home institution, which is a small program.
I want to pursue fellowship, and this program's emphasis is on creating generalists and doesn't have a great track record of getting people into fellowships.
I had great recommendation letters/dean's letter and Step 1 in high 220's and Step 2 low 240's. I had extracurricular activities but no research.
I applied to a good mix of midsize university and community programs, but didn't match at any of those, despite getting good feedback.

I definitely want to leave my program and want to know the best way to approach the PD, without stepping on any toes.

What are my options? Should I reenter the match as a PGY-1 or look for a PGY-2 position for 2014?

Thanks in advance.

Don't leave your program. Be happy you matched. Leaving will place a red flag on your application and you may not ever get another program. Suck it up and be the best doctor you can be. Just like medical school, it's up to you to make it work. The program is not going to give you a fellowship = you are. At least do the intern year before trying to swap programs as a PGY-2. It will be less difficult, but not easy.

 

[Substance]

Don't leave your program. Be happy you matched. Leaving will place a red flag on your application and you may not ever get another program. Suck it up and be the best doctor you can be. Just like medical school, it's up to you to make it work. The program is not going to give you a fellowship = you are. At least do the intern year before trying to swap programs as a PGY-2. It will be less difficult, but not easy.

Sounds like the OP really sucks. I mean, if you match at the bottom of your list, what makes you think better programs would want you. Your entire worth in your career is dictated by your match.

 

[smartsandwich]

I'm a PGY3 in OB who was in a similar situation as yourself.

Reentering the match is not the greatest option to be honest. You'd be damaged goods and PDs wouldn't trust you the second time around.

If you are dead set on leaving, your best bet would be to complete your PGY1 year and potentially starting a PGY2 year elsewhere. The CREOG Clearinghouse lists open positions. OB GYN has a relatively high attrition rate and openings do occur.

What fellowship are you interested in specifically? MFM, REI, Gyn Onc, or Urogyn?

Your best best bet would be to stick with your current program (especially if it is a good training environment), do well on your CREOGs, do some clinical research in your fellowship area of interest, and potentially do an away rotation during your third year and apply for fellowship.

I matched near the bottom of my list in a community program in a city most people have never heard of. I was contemplating leaving but gladly didn't. The program has trained me into being a good doctor and has supported my fellowship endeavors without hesitation. I'm in the middle of the application process for fellowship and am getting a good number of interviews from well known programs.

Love the one you got.

I am interested in MFM but I don't know if that will change. My program has only two MFMs but I am worried about the the amount of research and whether I will be able to publish.

 

[deleted87716]

Don't leave your program. Be happy you matched.

Yep.

 

[Shjanzey]

.

 

[samsoniter]

Many people would kill just to match. Quit your whining.

"Your entire worth in your career is dictated by your match."

for the record, this is one of the most ignorant statements I have ever heard! I know a few people who didn't match at all, and are now kicking serious ***** in top 5 programs, so for anyone dumb enough to believe their self worth is related to their ROL# I say go ahead.

 

[Shjanzey]

.

 

[TexasPhysician]

I am interested in MFM but I don't know if that will change. My program has only two MFMs but I am worried about the the amount of research and whether I will be able to publish.

You are over thinking this. You can publish anywhere if you put forth the effort. Stay where you are and make the best of it. 2 MFM's is plenty.

 

[survivordo]

I don't see what you would gain by leaving the program at this point... you didn't match into one of your preferred programs so where would you plan on going? Complete intern year, get a feel for it, then if you are still unhappy look for advanced positions. As others have said, be happy you matched into your preferred specialty.

Survivor DO

 

[anonperson]

I am interested in MFM but I don't know if that will change. My program has only two MFMs but I am worried about the the amount of research and whether I will be able to publish.

You'll be fine. Write up a couple of chart reviews and present them at SMFM and if you're really dying, do an away rotation at a bigger program to potentially get another letter of recommendation. There are a good amount of MFM fellowships out there compared to REI or Gyn Onc and you can match if you show some interest.

Also, you can publish a project from any institution, even community ones. Just find a doable project and start working on it in intern year.

 

[da8s0859q]

Sounds like the OP really sucks. I mean, if you match at the bottom of your list, what makes you think better programs would want you. Your entire worth in your career is dictated by your match.

Someone's entire career worth is dictated by a computer algorithm and the unpredictability of interview cycles and rank lists?

 

[CambieMD]

I'm a PGY3 in OB who was in a similar situation as yourself.

Reentering the match is not the greatest option to be honest. You'd be damaged goods and PDs wouldn't trust you the second time around.

If you are dead set on leaving, your best bet would be to complete your PGY1 year and potentially starting a PGY2 year elsewhere. The CREOG Clearinghouse lists open positions. OB GYN has a relatively high attrition rate and openings do occur.

What fellowship are you interested in specifically? MFM, REI, Gyn Onc, or Urogyn?

Your best best bet would be to stick with your current program (especially if it is a good training environment), do well on your CREOGs, do some clinical research in your fellowship area of interest, and potentially do an away rotation during your third year and apply for fellowship.

I matched near the bottom of my list in a community program in a city most people have never heard of. I was contemplating leaving but gladly didn't. The program has trained me into being a good doctor and has supported my fellowship endeavors without hesitation. I'm in the middle of the application process for fellowship and am getting a good number of interviews from well known programs.

Love the one you got.

This is great advice. The program doesn't make you. You make you. Work hard to be the best resident in the program and do the other things that anonperson mentioned.

Cambie

 

[QofQuimica]

"Your entire worth in your career is dictated by your match."

for the record, this is one of the most ignorant statements I have ever heard! I know a few people who didn't match at all, and are now kicking serious ***** in top 5 programs, so for anyone dumb enough to believe their self worth is related to their ROL# I say go ahead.

Someone's entire career worth is dictated by a computer algorithm and the unpredictability of interview cycles and rank lists?

I'm maybe going out on a limb here, but I'd guess that Substance was being sarcastic.

OP, agree with the others. You got a residency, and you'll graduate from it able to get yourself a license and spend the rest of your career practicing in the specialty you want. Keep that fact in mind and focus on becoming the best OB/gyn you can. And don't be so sure that life would be all that much better had you matched higher on your list. I matched to my first choice, and suffice it to say that I didn't like it nearly as much as I thought I would.

 

[cabinbuilder]

I'm maybe going out on a limb here, but I'd guess that Substance was being sarcastic.

OP, agree with the others. You got a residency, and you'll graduate from it able to get yourself a license and spend the rest of your career practicing in the specialty you want. Keep that fact in mind and focus on becoming the best OB/gyn you can. And don't be so sure that life would be all that much better had you matched higher on your list. I matched to my first choice, and suffice it to say that I didn't like it nearly as much as I thought I would.

On the flip side of this. I DID NOT MATCH and had to scramble. Had the best time in residency ever, could never have planned such a great fit. Just be positive, learn all you can, and be the best doctor you were meant to be.

 

[da8s0859q]

I'm maybe going out on a limb here, but I'd guess that Substance was being sarcastic.

OP, agree with the others. You got a residency, and you'll graduate from it able to get yourself a license and spend the rest of your career practicing in the specialty you want. Keep that fact in mind and focus on becoming the best OB/gyn you can. And don't be so sure that life would be all that much better had you matched higher on your list. I matched to my first choice, and suffice it to say that I didn't like it nearly as much as I thought I would.

I hope so. He just struck a nerve. I was fortunate enough to get one of the top few of my list for EM this year, but it's taking me a long, long way away from everyone I care about.

 

[billybob746]

people dont want to hear about your relationship via the internet. or at all. but def not over the internet.

 

[45408]

Don't leave your program. Be happy you matched. Leaving will place a red flag on your application and you may not ever get another program. Suck it up and be the best doctor you can be. Just like medical school, it's up to you to make it work. The program is not going to give you a fellowship = you are. At least do the intern year before trying to swap programs as a PGY-2. It will be less difficult, but not easy.

This, absolutely this.

You matched. If you could have matched higher, you would have. You might not find another place at all if you try again, and you'll have left a very bitter taste with your current PD, which could follow you around for years.

 

[umean2tellme]

If the OP were to reapply for next year's match they won't get a spot. I can't wait to read that thread next March.

 

[fizzle]

Someone's entire career worth is dictated by a computer algorithm and the unpredictability of interview cycles and rank lists?

A computer only acts according to the instructions fed to it by humans. And I'd take the relatively subjectivity-free approach of the match algorithm over the games that programs and applicants used to play before the computer system came around.

 

[cowme]

A computer only acts according to the instructions fed to it by humans. And I'd take the relatively subjectivity-free approach of the match algorithm over the games that programs and applicants used to play before the computer system came around.

The old system was much less subjective, IMO.

In the old days, you would interview, and then be offered a position on the spot if they liked you, with a week to take it or leave it. If you wanted to spot, you say yes, and finish interviewing. If you wanted something else more, you say no, and interview elsewhere. It was pretty simple, and more indicative of a real world job hunt

Today, you flirt with 15 programs, 10 of which you don't really want to attend, but still try to feign enough interest "just in case" the top 5 programs don't like you back, while the other side obsesses over every gesture and statement you make on a 4 hour visit.

 

[JGimpel]

Don't leave the program you matched into for any reason. It's incredibly difficult to do and still have options and is offensive to your current program in a way that insures that the rest of your residency there will suck. With all the stuff I'm hearing about the AMA match this year, you won't stand a chance next year if you quit your program this year.

 

[NotAProgDirector]

The old system was much less subjective, IMO.

In the old days, you would interview, and then be offered a position on the spot if they liked you, with a week to take it or leave it. If you wanted to spot, you say yes, and finish interviewing. If you wanted something else more, you say no, and interview elsewhere. It was pretty simple, and more indicative of a real world job hunt

Today, you flirt with 15 programs, 10 of which you don't really want to attend, but still try to feign enough interest "just in case" the top 5 programs don't like you back, while the other side obsesses over every gesture and statement you make on a 4 hour visit.

We can certainly debate the pros and cons of a match. But let's be clear about what happened in the old system. Yes, you'd interview at a program, and they would offer you a position on the spot. You;d then need to sign the contract and stop interviewing, or move on.

But remember that if you move on, you lose the spot you were offered. And taking a spot / signing a contract and continuing to interview would be a contract violation (and unprofessional). So, you'd need to decide whether to take the first spot you're offered, or risk it all and continue to interview. less competitive programs would be driven to interview earlier to try to lock people in. If you got an interview from your "top choice" but it was late in the season, you'd be screwed -- since you'd have to decide whether to simply "risk it". Plus, since spots could fill at any time, if you have an interview late in the season you might get a call from the program telling you that all the spots were filled, so sorry.

The old system had many problems. I personally think the match is a better balance. Others may disagree.

 

[cowme]

exactly, but this is how the real world works. You can take down the first chub that makes eye contact with you at the bar, or you can put all your efforts into that beauty knowing full well you could go home alone.

There's pros and cons to both systems, like you said. But some people would rather roll the dice with the few programs they truly want, rather than fake it with 10 places they have 0 interest in.

 

[IamnotFreud]

exactly, but this is how the real world works. You can take down the first chub that makes eye contact with you at the bar, or you can put all your efforts into that beauty knowing full well you could go home alone.

There's pros and cons to both systems, like you said. But some people would rather roll the dice with the few programs they truly want, rather than fake it with 10 places they have 0 interest in.

I absolutely agree. This whole hting about going to a bunch of IVs because you don't know where you'll end up is absurd. I matched at the first place I interviewed. I had a good feeling about it too, thought they liked me, I liked them, there was a good mesh.

If they would have offered me the spot then I would have likely taken it. I think a lot of people would take spots at programs they like and it would be far less costly and less BS. It has become an absurd game. why can't we have a system where program interviews X number of people and offers the people they like spots. If applicants don't want them, then they move on, and so does the program. That works in the real world as well. Why can't we go back to that? That would also eliminate programs having to sort through hundreds of apps as well, and waiting for weeks ot find out if we matched.

 

[dpmd]

exactly, but this is how the real world works. You can take down the first chub that makes eye contact with you at the bar, or you can put all your efforts into that beauty knowing full well you could go home alone.

There's pros and cons to both systems, like you said. But some people would rather roll the dice with the few programs they truly want, rather than fake it with 10 places they have 0 interest in.

That is not how the real world works. In the real world all possible jobs are not available for the same start date with the need to hire such a large quantity of people at the same time. You don't have to deal with multiple companies offering you an interview, but they are all on the same date so you would have to miss others in order to go to one (something that used to happen frequently in the old system). The match isn't the reason people apply to multiple programs. It isn't like people in the old system would just apply to 3 programs, because they would be screwed if those 3 programs didn't offer them a position. If you truly had zero interest in a program, there is no reason you should have applied there. The idea is you apply to all the places you think you would like to go, you then interview at whichever of those programs also thought they might like to take you, then you make a list of who you like best. The programs do a similar thing, then a computer attempts to maximize happiness. In the old system you might interview at your fourth choice first, get an offer and take it because you are risk averse. It is possible that, if you had held out, your first choice program would have offered you a position. In the old system you would have no way of knowing. In the match system, they way you get to know is that you end up matching at your number one or you end up lower on your rank list. Perhaps you guys are confused because you thought your number one liked you enough to match there, and you think the match somehow screwed you out of it? That is just wrong.

 

[cowme]

so risk averse in the old system was taking a spot at your #3 program on your first interview

risk averse in today's system is interviewing at 16 programs, including a handful of "just in case" safeties that you will only use as a last resort (and maybe even not rank at all)

Yea...I'll take the old system. The old system is how fellowship placements still work in radiology, and it isn't nearly as much gamesmanship and insanity as the match. If you can't make one of your top two interview dates because of overlapping dates, you pick the one you like more. You get an offer you like enough to end the process, you take it. End of story.

 

[dpmd]

so risk averse in the old system was taking a spot at your #3 program on your first interview

No, a risk averse but highly desirable applicant might take the first offer at their # 3. Others might have their last choice interview first and have to decide whether to gamble on a better program or not. What makes you think that you wouldn't have those same 16 interview choices in the old system, with the difference being that those safeties that you might not even rank are the ones who interview the earliest? How do you even really know which programs you will like best before you get to meet with the people at them? Are you convinced that you would have gone to a program you liked better if there wasn't a match system?

Many fellowships now use the match as well, including a lot of radiology fellowships. Not sure what gamesmanship and insanity you are talking about for the match. You apply to programs you have interest in, interview at those that have interest in you, decide where you wish to go and a computer tries to send you there (unless where you want to goes doesn't want you enough). All this nonsense people talk about altering your rank order list to ensure you match, or other things people advise to game the system is nothing more than inability to understand the simplicity of the system.

 

[Law2Doc]

so risk averse in the old system was taking a spot at your #3 program on your first interview

risk averse in today's system is interviewing at 16 programs, including a handful of "just in case" safeties that you will only use as a last resort (and maybe even not rank at all)

Yea...I'll take the old system. The old system is how fellowship placements still work in radiology, and it isn't nearly as much gamesmanship and insanity as the match. If you can't make one of your top two interview dates because of overlapping dates, you pick the one you like more. You get an offer you like enough to end the process, you take it. End of story.

Interesting that you use radiology as a positive example, considering that field is generally unhappy with how their fellowship process works, due to tons of gamesmanship and with programs each trying to interview earlier and earlier each year and force people to make decisions before seeing other places.

 

[smq123]

The old system was much less subjective, IMO.

In the old days, you would interview, and then be offered a position on the spot if they liked you, with a week to take it or leave it. If you wanted to spot, you say yes, and finish interviewing. If you wanted something else more, you say no, and interview elsewhere. It was pretty simple, and more indicative of a real world job hunt

Today, you flirt with 15 programs, 10 of which you don't really want to attend, but still try to feign enough interest "just in case" the top 5 programs don't like you back, while the other side obsesses over every gesture and statement you make on a 4 hour visit.

Having been through the real world job hunt, it makes the match look really good.

You don't know if you're applying early or if you're late. You don't know which jobs really have openings. You feel like you don't have a lot of time to think about it, because you don't want them to give the job to someone else. And then the whole "letter of intent," with the verbal assurance that your contract WILL be coming sometime before you start, is a little unnerving as well.

 

[southsidebear]

I know that you did not match where you wanted but at least you matched somewhere. A lot of people did not match anywhere.

 

[Textbookversion]

so risk averse in the old system was taking a spot at your #3 program on your first interview

risk averse in today's system is interviewing at 16 programs, including a handful of "just in case" safeties that you will only use as a last resort (and maybe even not rank at all)

Yea...I'll take the old system. The old system is how fellowship placements still work in radiology, and it isn't nearly as much gamesmanship and insanity as the match. If you can't make one of your top two interview dates because of overlapping dates, you pick the one you like more. You get an offer you like enough to end the process, you take it. End of story.

I don't know what they are pumping into the air vents in your hospital, but it's clearly not having the intended effect. I don't understand how a rational person could prefer the old system over the match.

 

[Dral]

I don't know what they are pumping into the air vents in your hospital, but it's clearly not having the intended effect. I don't understand how a rational person could prefer the old system over the match.

For real. The old system worked back in te day when, to quote an older Pathologist I shadowed " I applied to one med school and went there. I applied to one residency and went there". There are too many people and programs for that old way to be pleasurable or even pragmatic and efficient now.

 

[IMvrach]

Agree. Residency placement problem is quite well defined and the match algorithm under some measure provides theoretically optimal solution. Why nobody considers opening a dating site using the same idea? 😀

I don't know what they are pumping into the air vents in your hospital, but it's clearly not having the intended effect. I don't understand how a rational person could prefer the old system over the match.

 

[kjamess]

I don't know what they are pumping into the air vents in your hospital, but it's clearly not having the intended effect. I don't understand how a rational person could prefer the old system over the match.

Exactly. The old system sounds like the worst compared to what we have now. I would gladly have to interview at a few more safeties to have a shot at matching at my preferred program, rather than having to "settle" with my #6 because of the reasons aPD mentioned.

 

[Substance]

I'm maybe going out on a limb here, but I'd guess that Substance was being sarcastic.

With my tongue in my cheek, yes.

But there is a bit of truth to that comment. Witness the variety of programs that will not interview applicants just because they're in a residency in another specialty. Also witness programs that will not interview anyone from certain fields (FP, IM, path and psych) because the assumption is that the applicant did not get their first choice and ended up in one of those fields as a backup, and that makes them losers.