How about starting to talk about our 2017 rank lists?

[misteratoz]

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[Gern Blansten]

You are wrong--you are not penalized in any way by falling to your 2nd or even 16th choice, rather than ranking them higher.

Let's say program X has 10 spots, and they rank you #20 on their list (out of 100 applicants). Let's say 9 of those 20 applicants ahead of you rank the program highly and are matched there. Even if you ranked program X dead last on your list, you will still be able to claim that last spot.

It doesn't matter if, for the first 15 cycles of your application you are unsuccessfully paired with other programs, on the 16 cycle you will cut in front of the other 80 applicants to claim the last spot.

Watch the NRMP video that was posted earlier. You should disregard your likelihood of matching to a program, and only rank them in the order that you truly prefer them.

^^^What they said. Rank them in the order you want to attend their programs. If they fall to where you are on their list, you will be picked up in the match by the program that you ranked the highest that also fell down low enough on their list to pick you up. Don't over analyze it. Just put them in the order that you want based on your desire to match at the program.

 

[stepone2015]

^^^What they said. Rank them in the order you want to attend their programs. If they fall to where you are on their list, you will be picked up in the match by the program that you ranked the highest that also fell down low enough on their list to pick you up. Don't over analyze it. Just put them in the order that you want based on your desire to match at the program.

I seriously don't even understand why people keep asking the same question, getting the same answer, then asking again. Just rank your preference and wait for March.

 

[Psai]

I seriously don't even understand why people keep asking the same question, getting the same answer, then asking again. Just rank your preference and wait for March.

This entire thread is based on one person who can't make up their mind and doesn't understand that "rank it in order of preference" means "rank it in order of preference"

 

[nimbus]

 

[nimbus]

Is it feasible at all to live in NYC on a resident's salary??

Yes literally thousands of residents do it. Same for Boston, San Fran, LA, etc.

 

[26B]

I really do hope he matches at Penn... for my own sake

This entire thread is based on one person who can't make up their mind and doesn't understand that "rank it in order of preference" means "rank it in order of preference"

 

[abolt18]

I seriously don't even understand why people keep asking the same question, getting the same answer, then asking again. Just rank your preference and wait for March.

I can't even tell you how many times I've had to explain this to classmates and underclassmen. Thank goodness for YouTube videos that explain it clearly.

 

[Car-e-monda]

Also think about it this way, programs have to make two separate lists, on for categorical and one for advanced positions. This means that if you do place an advanced program high on your list you will be more likely to match there (assuming that the advanced position is less competitive). In other words, a lot of other applicants won't rank the advanced positions as high, giving you the edge. Rank in order of preference.

So first of all, why would the algorithm necessarily favor the applicant? I don't have a clear explanation on that. Let me run this hypothetical by you all.

Let's say my top program has not ranked me high enough to match even if it were my top choice. This is possible ONLY if other more highly ranked candidates also chose my top choice as their top choice and the programs fills all its seats. This situation is obviously very possible and in my case, maybe even likely.

There are 2 scenarios given this reality:

Scenario 1: I ranked my top choice as categorical only. The remainder of my list looks the same.
Scenario 2: I ranked my top choice as categorical and advanced filling spots 1 and 2. The rest of my list is bumped down 1.

If I weren't ranked to match, wouldn't scenario 2 screw me worse in the match? Meaning, given that I can't match into my top choice, scenario 1 would offer me an earlier and thus higher chance at matching into the remaining programs than scenario 2 would. This is because (as I understand it) the algorithm has gone through an additional cycle before matching me at my 2nd choice.

Someone please correct me if I'm wrong. I sincerely hope that I am.

Also think about it this way, programs have to make two separate lists, on for categorical and one for advanced positions. This means that if you do place an advanced program high on your list you will be more likely to match there (assuming that the advanced position is less competitive). In other words, a lot of other applicants won't rank the advanced positions as high, giving you the edge. Rank in order of preference.

 

[deleted547339]

Yes literally thousands of residents do it. Same for Boston, San Fran, LA, etc.

Yes, but many of those go into additional debt or have family help.

 

[nimbus]

Yes, but many of those go into additional debt or have family help.

If you're married with kids and a stay at home spouse it's very difficult. If you're single or have working spouse it's easily doable without going into more debt. I was a medical student and intern in NYC. You can actually live very cheap there if you're willing to slum it. Rent is high but you don't need a car and eating can be a less than $20/day. And there are literally thousands of free things you can do there for entertainment

 

[Temeraire]

Yes, but many of those go into additional debt or have family help.

I live in one of the most expensive parts of the Bay Area. My partner makes about as much as I do (i.e. like a PGY-1 salary). We don't feel poor at all. We live in a 1BR with a private backyard, and we have enough spare change to splurge on the occasional weekend trip to Napa, Sonoma, Sausalito, Santa Cruz, Tahoe, etc. Granted, neither of us have any educational debts, and and we don't have kids yet. But even if I did have debt, I would easily be be able to pay about $1000/month towards it from my own salary (that money is going into savings instead).

I know interns who have kids, but both spouses work. I could see how supporting a SAHM/D with kids might get dicey though.

 

[jd8]

Blah

 

[deleted171991]

When you choose your program, look for one which has SICK BREAD AND BUTTER cases. Don't be impressed by fancy-shmancy surgical procedures that have minimal anesthetic impact. Be impressed by sick as hell patients, the kind one wonders if they should operate on, coming for everyday procedures. Be impressed by procedures with a lot of blood loss and hemodynamic instability, trauma, and long open procedures (not laparoscopic/robotic/minimally invasive ones, unless for stuff like endocrine tumors or cardiothoracic surgery). In anesthesia, minimally invasive = maximally non-educational, most of the time. If the residents have time to read/sit/use their smartphone/get bored during many cases, they are not getting the best education.

That's why cardiac experience is good, because most of those people are anything but healthy. That's why ENT experience or rotation is good, because you deal with a lot of crappy airways. (You'll want an obese population, or bariatric surgeries, for the same reason.) That's why really high risk OB without a fellow to steal the best cases is good, because you want to do the 450 pounder or the severe pre-eclampsia patient. That's why a significant VA rotation is good (not just one or two months), because of all the sick chain smokers there. Peds doesn't matter that much, because sick kids should not be done by generalists, and more and more not even the healthy ones are. Same for pain; you won't want to do pain procedures without a fellowship, unless your name is Noyac (or was it Sevo?).

Also, look at their regional program. You want a place where regional anesthesia is not a second rate citizen, a place where there is no special regional anesthesia rotation, for the simple reason that everybody does regional almost every day, including on call, and the surgeons don't get to choose/refuse whether their patient gets a regional anesthetic, even if just for post-op analgesia. Don't be fooled by the "top" name of the program, if regional is weak; it's more important than what they make it look like in cacademia. There is a lot of ortho out outside of cacademia, and a lot of sick patients that do better with regional anesthetics, and one needs a good grasp of it to be a well-rounded anesthesiologist. Plus, since most places are becoming corporate, fewer and fewer groups will teach it to you after graduation. You'll want a place where you'll do 10+ epidurals in 12 hours, not one where you sleep half of the night when on OB; it's nice and cushy, except cushy training is almost synonymous with bad (unless you're old and senile like me and need your beast beauty sleep).

You'll want a place where the ultrasound machine is everywhere you look, not just for peripheral nerve blocks. Where they teach you at least basic TEE and TTE, maybe even lung, airway, spine and gastric ultrasound, maybe with a dedicated ultrasound rotation. Where there is no standard way of providing anesthesia for most procedures, and every attending is different with a different background and a different way to skin the cat; a lot of people with PP experience, not just inbred old boys/girls who got a job in their own programs after graduation, and keep doing things the same "local" way (most of them). Where attendings spend a lot of the time in the OR, and not chatting outside or working on their academic promotions. Again, you'll be surprised how many of the "top" programs suffer from this cancer.

You'll want a place with many electives, because that says that the program cares about your education, not just about having a cheap body in the OR.

Don't prepare for an academic "career". There is no such thing, except for brown-nosers, and used car salesmen disguised as "researchers". (The bigger a place is, the more irrelevant true professional skills become.) Also, many academics are actually lowly corporate staff anesthesiologists, AKA assistant "professors" and "instructors" who mostly work with CRNAs (who do most of the cases even in academia) or solo. Prepare to be fantastic in private practice, because that's 90% of the job market, and that's the place where people actually appreciate if you're clinically great.

P.S. And just to clarify my previous posts: I am not a fan of long hours during residency, just of many educationally meaningful hours.

 

[Dam272]

When you choose your program, look for one which has SICK BREAD AND BUTTER cases. Don't be impressed by fancy-shmancy surgical procedures that have minimal anesthetic impact. Be impressed by sick as hell patients, the kind one wonders if they should operate on, coming for everyday procedures. Be impressed by procedures with a lot of blood loss and hemodynamic instability, trauma, and long open procedures (not laparoscopic/robotic/minimally invasive ones, unless for stuff like endocrine tumors or cardiothoracic surgery). In anesthesia, minimally invasive = maximally non-educational, most of the time. If the residents have time to read/sit/use their smartphone/get bored during many cases, they are not getting the best education.

That's why cardiac experience is good, because most of those people are anything but healthy. That's why ENT experience or rotation is good, because you deal with a lot of crappy airways. (You'll want an obese population, or bariatric surgeries, for the same reason.) That's why really high risk OB without a fellow to steal the best cases is good, because you want to do the 450 pounder or the severe pre-eclampsia patient. That's why a significant VA rotation is good (not just one or two months), because of all the sick chain smokers there. Peds doesn't matter that much, because sick kids should not be done by generalists, and more and more not even the healthy ones are. Same for pain; you won't want to do pain procedures without a fellowship, unless your name is Noyac (or was it Sevo?).

Also, look at their regional program. You want a place where regional anesthesia is not a second rate citizen, a place where there is no special regional anesthesia rotation, for the simple reason that everybody does regional almost every day, including on call, and the surgeons don't get to choose/refuse whether their patient gets a regional anesthetic, even if just for post-op analgesia. Don't be fooled by the "top" name of the program, if regional is weak; it's more important than what they make it look like in cacademia. There is a lot of ortho out outside of cacademia, and a lot of sick patients that do better with regional anesthetics, and one needs a good grasp of it to be a well-rounded anesthesiologist. Plus, since most places are becoming corporate, fewer and fewer groups will teach it to you after graduation. You'll want a place where you'll do 10+ epidurals in 12 hours, not one where you sleep half of the night when on OB; it's nice and cushy, except cushy training is almost synonymous with bad (unless you're old and senile like me and need your beast beauty sleep).

You'll want a place where the ultrasound machine is everywhere you look, not just for peripheral nerve blocks. Where they teach you at least basic TEE and TTE, maybe even lung, airway, spine and gastric ultrasound, maybe with a dedicated ultrasound rotation. Where there is no standard way of doing procedures, and every attending is different with a different background and a different way to skin the cat; a lot of people with PP experience, not just inbred old boys/girls who got a job in their own programs after graduation, and keep doing things the same "local" way (most of them). Where attendings spend a lot of the time in the OR, and not chatting outside or working on their academic promotions. Again, you'll be surprised how many of the "top" programs suffer from this cancer.

You'll want a place with many electives, because that says that the program cares about your education, not just about having a cheap body in the OR.

Don't prepare for an academic "career". There is no such thing, except for brown-nosers, and used car salesmen disguised as "researchers". (The bigger a place is, the more irrelevant true professional skills become.) Also, many academics are actually lowly corporate staff anesthesiologists, AKA assistant "professors" and "instructors" who mostly work with CRNAs (who do most of the cases even in academia) or solo. Prepare to be fantastic in private practice, because that's 90% of the job market, and that's the place where people actually appreciate if you're clinically great.

The most insightful and helpful post i needed to go through right before submission of the ROl. Thanks a ton @FFP for spending time to type this message

 

[deleted162650]

Pick a place with sh*tty surgeons. Mopping up after sloppy surgeons makes for great anesthetic training.

 

[abolt18]

When you choose your program, look for one which has SICK BREAD AND BUTTER cases. Don't be impressed by fancy-shmancy surgical procedures that have minimal anesthetic impact. Be impressed by sick as hell patients, the kind one wonders if they should operate on, coming for everyday procedures. Be impressed by procedures with a lot of blood loss and hemodynamic instability, trauma, and long open procedures (not laparoscopic/robotic/minimally invasive ones, unless for stuff like endocrine tumors or cardiothoracic surgery). In anesthesia, minimally invasive = maximally non-educational, most of the time. If the residents have time to read/sit/use their smartphone/get bored during many cases, they are not getting the best education.

That's why cardiac experience is good, because most of those people are anything but healthy. That's why ENT experience or rotation is good, because you deal with a lot of crappy airways. (You'll want an obese population, or bariatric surgeries, for the same reason.) That's why really high risk OB without a fellow to steal the best cases is good, because you want to do the 450 pounder or the severe pre-eclampsia patient. That's why a significant VA rotation is good (not just one or two months), because of all the sick chain smokers there. Peds doesn't matter that much, because sick kids should not be done by generalists, and more and more not even the healthy ones are. Same for pain; you won't want to do pain procedures without a fellowship, unless your name is Noyac (or was it Sevo?).

Also, look at their regional program. You want a place where regional anesthesia is not a second rate citizen, a place where there is no special regional anesthesia rotation, for the simple reason that everybody does regional almost every day, including on call, and the surgeons don't get to choose/refuse whether their patient gets a regional anesthetic, even if just for post-op analgesia. Don't be fooled by the "top" name of the program, if regional is weak; it's more important than what they make it look like in cacademia. There is a lot of ortho out outside of cacademia, and a lot of sick patients that do better with regional anesthetics, and one needs a good grasp of it to be a well-rounded anesthesiologist. Plus, since most places are becoming corporate, fewer and fewer groups will teach it to you after graduation. You'll want a place where you'll do 10+ epidurals in 12 hours, not one where you sleep half of the night when on OB; it's nice and cushy, except cushy training is almost synonymous with bad (unless you're old and senile like me and need your beast beauty sleep).

You'll want a place where the ultrasound machine is everywhere you look, not just for peripheral nerve blocks. Where they teach you at least basic TEE and TTE, maybe even lung, airway, spine and gastric ultrasound, maybe with a dedicated ultrasound rotation. Where there is no standard way of doing procedures, and every attending is different with a different background and a different way to skin the cat; a lot of people with PP experience, not just inbred old boys/girls who got a job in their own programs after graduation, and keep doing things the same "local" way (most of them). Where attendings spend a lot of the time in the OR, and not chatting outside or working on their academic promotions. Again, you'll be surprised how many of the "top" programs suffer from this cancer.

You'll want a place with many electives, because that says that the program cares about your education, not just about having a cheap body in the OR.

Don't prepare for an academic "career". There is no such thing, except for brown-nosers, and used car salesmen disguised as "researchers". (The bigger a place is, the more irrelevant true professional skills become.) Also, many academics are actually lowly corporate staff anesthesiologists, AKA assistant "professors" and "instructors" who mostly work with CRNAs (who do most of the cases even in academia) or solo. Prepare to be fantastic in private practice, because that's 90% of the job market, and that's the place where people actually appreciate if you're clinically great.

Wish I could have read this post before interview season started! Most of the interviews I just felt like I had no idea what measuring stick to use in comparing programs. Finally just went with my gut. Thanks for your input FFP.

 

[GoSoxGo]

Don't prepare for an academic "career". There is no such thing, except for brown-nosers, and used car salesmen disguised as "researchers". (The bigger a place is, the more irrelevant true professional skills become.) Also, many academics are actually lowly corporate staff anesthesiologists, AKA assistant "professors" and "instructors" who mostly work with CRNAs (who do most of the cases even in academia) or solo. Prepare to be fantastic in private practice, because that's 90% of the job market, and that's the place where people actually appreciate if you're clinically great.
.

This is funny. So who is going to teach these applicants how to take of these SICK BREAD AND BUTTER cases at the academic center they end up at as a CA-1? The full professors? The CRNA's? You, via this forum? Or they'll just teach themselves, figure it out on the fly? Won't be junior faculty, they'll all be doing their own cases. In the end it probably doesn't really matter because residents won't actually appreciate learning from someone that is 'clinically great' since it's not PP.

 

[deleted171991]

This is funny. So who is going to teach these applicants how to take of these SICK BREAD AND BUTTER cases at the academic center they end up at as a CA-1? The full professors? The CRNA's? You, via this forum? Or they'll just teach themselves, figure it out on the fly? Won't be junior faculty, they'll all be doing their own cases. In the end it probably doesn't really matter because residents won't actually appreciate learning from someone that is 'clinically great' since it's not PP.

You are misunderstanding my post. I have the utmost respect for some of the people who taught me, many of them in junior academic ranks. They should be more appreciated and much higher ranked. The fact that they are not, and many less deserving others are, speaks volumes to me about what a lottery an academic "career" is. It does not value clinical excellence, not even educational one; it's nothing more than an AMC career in disguise. I have friends who are outstanding physicians and fantastic teachers, with absolutely amazing reviews from trainees and patients every single year, who are still assistant professors, while average Joe who is only good at working the system passes them by, at Ferrari speed, on the academic ladder. Unfortunately, by the time people figure out what a rat race academia is, it's 10-15 years later. I have seen this time and time again.

A traditional PP partnership, with 10-20 docs or EWYK, can offer a much better satisfaction and appreciation of somebody's talents... and defects.