How do programs remember interviewees?

[oompa loompa]

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I'm aware this may differ among programs, but I was wondering how the process of ranking interviewees throughout the interview cycle occurs. Do programs rank us after the interview, or put us in groups (most desirable to least desirable) and then convene one final time in February to decide on a final list? I'm aware I have no control over this, but knowing how it works is somehow comforting.

Thanks!

 

[blz]

At a program I interviewed at recently, I was told by the residents that they rank us right after the interview. I'm not sure if it's the norm but I feel like it's the best time to do ranking as it would be unfair for very early interviewees if they just picked a day in feb to do it.

 

[WhoisJohnGalt]

At a program I interviewed at recently, I was told by the residents that they rank us right after the interview. I'm not sure if it's the norm but I feel like it's the best time to do ranking as it would be unfair for very early interviewees if they just picked a day in feb to do it.

*nod* My understanding is that you're scored numerically right after your interview, and all they do in Feb is order the numerical scores. I suppose if there's a tie it might be beneficial to have interviewed more recently, but studies have shown you're not really at an advantage by interviewing later so I guess that doesn't happen very often.

 

[scpod]

I've actually asked this question at all the interviews I've done and it seems as if there is more than one way. One place has everyone who sees the candidate score them after the interview and the GME director averages these all out. Other places have the residents rank you first in a meeting by showing your picture on a screen and rating you in Feb, then passing that on to the faculty who do the same thing. You have to hope that you are well-remembered in that type of system. Then, I've heard of hybrids of each of those types. I just don't think that there's a universal format. You might want to ask the places where you interview how they do it.

 

[Frugal Traveler]

For all we know, it could be a dart board and some alcohol for those fun-loving programs.

I think getting a great picture for your ERAS photo is a good idea.

I've heard of various systems, but in the end, it is not something worth worrying about too much... you go to places and hope you match! I have a feeling that your school, grades, and USMLE score count for the most and place you into a tier. The interview can only do so much. If you think of it like a diagnostic test... it can have huge negative LR and decrease your post-test probability of being ranked after the encounter if you screw up big.
It can have a LR of 1 (no change up or down), or if you make a good impression, maybe a LR of 2-3... which would not substantially change your ranking based on school, grades, and USMLE but would increase you somewhat.

I think the interview is just to make sure you are what you appear to be on paper, that you are presentable and sociable ... and you're not some crazy person obsessed with Farmville on Facebook.

 

[dmitrinyr]

For all we know, it could be a dart board and some alcohol for those fun-loving programs.

I think getting a great picture for your ERAS photo is a good idea.

I've heard of various systems, but in the end, it is not something worth worrying about too much... you go to places and hope you match! I have a feeling that your school, grades, and USMLE score count for the most and place you into a tier. The interview can only do so much. If you think of it like a diagnostic test... it can have huge negative LR and decrease your post-test probability of being ranked after the encounter if you screw up big.
It can have a LR of 1 (no change up or down), or if you make a good impression, maybe a LR of 2-3... which would not substantially change your ranking based on school, grades, and USMLE but would increase you somewhat.

I think the interview is just to make sure you are what you appear to be on paper, that you are presentable and sociable ... and you're not some crazy person obsessed with Farmville on Facebook.

Maybe this is not the best place to voice my displeasure but... if it is in fact the case and the interview is just a way to see that you are not crazy and doesn't count for too much, why are things like what school you went to and what scores you have so much more important. I did a medical intern year last year and along with my experience as a med student, I've meet some bad residents that came from great schools and probably had good scores, but lacked common sense and in the real world of medicine failed often. I've met foreign grads that were amazing doctors and cool people but maybe didn't do as great on USMLE. I've also met many foreign grads that had amazing USMLE scores (99s) and couldn't make a coherent sentence in English along with having no common sense in medicine and not being able to communicate with their fellow staff and families.

What I'm saying is: what exactly do good scores say about an applicant? Lets say that we have two applicants with good LORs, experience and both seem driven and normal based on the personal statement. One has a USMLE score of 220 and the other has a score of 205. So basically, lets say that one person got an extra 15-20 questions right on the test. If this is for a competitive residency specialty, the one with the lower score will probably not be granted an interview (almost regardless of the rest of his application and just based on his score). While the higher score person will be granted one and have his/her chance to impress people on interview day.

Then, fine... lets say that both interview and are great, very personable and friendly. Residents say that they wouldn't mind having either one as a future resident and interviewers are pleased with both. Now, if there is a scoring system, no matter how well the person with a lower score and from a foreign med school does on the interview... he/she will have a lower score and come rank time will get a lower rank. Why should they get a lower rank when the only thing that is different from the two applicants is the USMLE score? Will the person who scored higher be smarter, score better on the in-service exam, be a better doctor? What?

Sorry for the rant, but I'm trying to figure this out. My guess this is the kind of issue that we can talk about until our ears bleed and it doesn't matter as we are not making decisions on who gets interviews and who is left waiting and hoping only to find no invites and a message saying "i'm sorry you did not match" on match day.

 

[fever106]

Maybe this is not the best place to voice my displeasure but... if it is in fact the case and the interview is just a way to see that you are not crazy and doesn't count for too much, why are things like what school you went to and what scores you have so much more important. I did a medical intern year last year and along with my experience as a med student, I've meet some bad residents that came from great schools and probably had good scores, but lacked common sense and in the real world of medicine failed often. I've met foreign grads that were amazing doctors and cool people but maybe didn't do as great on USMLE. I've also met many foreign grads that had amazing USMLE scores (99s) and couldn't make a coherent sentence in English along with having no common sense in medicine and not being able to communicate with their fellow staff and families.

What I'm saying is: what exactly do good scores say about an applicant? Lets say that we have two applicants with good LORs, experience and both seem driven and normal based on the personal statement. One has a USMLE score of 220 and the other has a score of 205. So basically, lets say that one person got an extra 15-20 questions right on the test. If this is for a competitive residency specialty, the one with the lower score will probably not be granted an interview (almost regardless of the rest of his application and just based on his score). While the higher score person will be granted one and have his/her chance to impress people on interview day.

Then, fine... lets say that both interview and are great, very personable and friendly. Residents say that they wouldn't mind having either one as a future resident and interviewers are pleased with both. Now, if there is a scoring system, no matter how well the person with a lower score and from a foreign med school does on the interview... he/she will have a lower score and come rank time will get a lower rank. Why should they get a lower rank when the only thing that is different from the two applicants is the USMLE score? Will the person who scored higher be smarter, score better on the in-service exam, be a better doctor? What?

Sorry for the rant, but I'm trying to figure this out. My guess this is the kind of issue that we can talk about until our ears bleed and it doesn't matter as we are not making decisions on who gets interviews and who is left waiting and hoping only to find no invites and a message saying "i'm sorry you did not match" on match day.

I'm sorry this displeases you, but scores and grades matter, period. Yes being personable and all that is very important also, but you need another way to rank applicants. Knowledge base is a very important determinant in how well you will perform as a doctor. If you don't know your stuff, you won't be a good physician, period. And if two applicants are equally good in an interview, the spot should absolutely go to the person with better numbers. We are told from day one of med school that scores are important in the match. We all work hard for our scores and every one has an equal opportunity to study and learn the material in the best way they can. It is a competitive process, not a popularity contest. You seem to minimize the USMLE, but I'm sorry to break it to you, it is an important exam. It is the only way for programs to compare how well people have mastered the material across various medical schools. Some people are better standardized test takers than others, regardless of knowledge. But, you have two years of med school to work on your weaknesses and practice. People have the responsibility to do what is necessary for themselves to score well. If you don't score well, you don't deserve to take a match spot away from an equally personable applicant who did. Just my 2 cents.

 

[ResidentMD]

I'm sorry this displeases you, but scores and grades matter, period. Yes being personable and all that is very important also, but you need another way to rank applicants. Knowledge base is a very important determinant in how well you will perform as a doctor. If you don't know your stuff, you won't be a good physician, period. And if two applicants are equally good in an interview, the spot should absolutely go to the person with better numbers. We are told from day one of med school that scores are important in the match. We all work hard for our scores and every one has an equal opportunity to study and learn the material in the best way they can. It is a competitive process, not a popularity contest. You seem to minimize the USMLE, but I'm sorry to break it to you, it is an important exam. It is the only way for programs to compare how well people have mastered the material across various medical schools. Some people are better standardized test takers than others, regardless of knowledge. But, you have two years of med school to work on your weaknesses and practice. People have the responsibility to do what is necessary for themselves to score well. If you don't score well, you don't deserve to take a match spot away from an equally personable applicant who did. Just my 2 cents.

While I have seen the USMLE break many careers and have my issues regarding that exam as the sole screening point, I would have to agree mainly with the last three sentences in the above post.

 

[scpod]

....You seem to minimize the USMLE, but I'm sorry to break it to you, it is an important exam. It is the only way for programs to compare how well people have mastered the material across various medical schools....

I've been told differently by all 4 PDs and GME directors that I've interviewed with thus far. I asked them the same questions and they keep telling me your scores got you an interview, but we want to find out how well you fit in with our residents and our program-- because we don't want to work with an ******* over the next few years.

This isn't medical school anymore-- it's a real job. You will be working one-on-one with the team that's already in place. If you are a dick, but your scores are really high, you won't get the spot. One caveat, there may be some specialties where being a dick is the norm. You might get a spot there.

 

[synapse lapse]

If you don't score well, you don't deserve to take a match spot away from an equally personable applicant who did. Just my 2 cents.

While I agree with the gist of what you're saying, I disagree with this statement. The USMLE was not designed to stratify applicants based on scores, it is only designed as a basic competency test. The NBME has discussed changing the exam to pass/fail and combining steps 1/2 for this reason. While I don't think that's a good idea (as programs DO need an objective way to stratify applicants) it's not clear cut that step scores correlate strongly to future physician performance. In any case, as the above poster has said you are now interviewing for a job, and while scores will affect your invitation and ranking, I firmly believe they look for people they want to work with. After all, if you passed the steps (designed for competency evaluation) you will likely pass the boards, and that is basically the only number programs care about. Have you ever heard of a program mentioning avg step 1 scores of their residents? No. In the scenario where both people are equally a good fit personally, I think the better scores should probably win out (and would), barring any extraneous details... but life isn't like that. People are all individuals with quarks, and never are there 2 applicants exactly the same personality wise with only a difference in scores. In the end no one wants to work with a dick for 3+ years, so it is incumbent on them to find people they can tolerate/like. Ask yourself this, would you rather work with the smartest doctor in your field who is a total asshat all day, or would you rather work with a mediocre doctor who is awesome to be around? I think you'll see the answer - which will also demonstrate to you that the "smartest" people aren't necessarily the most successful in life in other areas as well, but likely social skills get you farther after a certain basic intelligence threshold is passed.

 

[fever106]

I don't think you guys quite understood my point. The other poster stated that he was bothered by the fact that of two applicants who perform equally well in the interview, the applicant with a higher score would be ranked higher. I think his argument is absurd. Yes, the interview is important, and if a person with a 270 is a total *****, I agree that they should be bumped way down on the list. However, the fact of the matter is, a lot like medical school applications, most people who have made it through 3.5 years of medical school can put it on for an interview. Most people will be on their best behavior and try to impress. Are there some total tools who can't keep it together, even for something as important as a formal interview, sure. And there are others who just lack a personality. But I promise you that programs will get waaaaaayyyyy more people who perform well in the interview than they have space for. And that is when these other factors (LORs, clinical grades, and yes, step 1 scores) come into play. It is impossible for a interviewer to make a decision between hundreds of applicants based solely, or even primarily, on a 30 min interview. It is one of many factors.

 

[dmitrinyr]

I don't think you guys quite understood my point. The other poster stated that he was bothered by the fact that of two applicants who perform equally well in the interview, the applicant with a higher score would be ranked higher. I think his argument is absurd. Yes, the interview is important, and if a person with a 270 is a total *****, I agree that they should be bumped way down on the list. However, the fact of the matter is, a lot like medical school applications, most people who have made it through 3.5 years of medical school can put it on for an interview. Most people will be on their best behavior and try to impress. Are there some total tools who can't keep it together, even for something as important as a formal interview, sure. And there are others who just lack a personality. But I promise you that programs will get waaaaaayyyyy more people who perform well in the interview than they have space for. And that is when these other factors (LORs, clinical grades, and yes, step 1 scores) come into play. It is impossible for a interviewer to make a decision between hundreds of applicants based solely, or even primarily, on a 30 min interview. It is one of many factors.

Why is my argument "absurd"? I don't think you guys are getting what I'm trying to say. The question is, if everything else is equal (i.e. clinical grades, great LORs, publishing, research, volunteering) between two applicants and the ONLY thing that is different is one has a good score (lets say 220) and the other has a slightly subpar score (lets say 205-210). Why is the applicant with automatically a "better" applicant and might get a chance at an interview over the first applicant... What just because he answered a few more questions correctly on a standardized exam? Will that really make him a better doctor? Maybe and maybe not. I'm also NOT talking about the extremes of the spectrum (i.e people who barely passed and those who scored a 270). Still, I understand that residentcy programs need a way to stratify and weed out applicants but does such a small difference in score really say THAT MUCH about an applicant? I am not sure at the answer as I've know people that are really good test takers and really smart, got 99 on steps and in clinical practice messed up as they had no common sense and had only book smarts. I've also known people that barely passed steps and were really good doctors and maybe were poorer test takers. Personally, I think that an interviewer can get a lot more from an interview than from an application and some things you just can't fake. I think some people deserve to be given a chance at an interview when their application is good despite a slightly lower score on USMLE, but I also understand that they can't interview everyone and they have to stratify somehow.

I think you guys (from your responses at least) already make up your mind that a better score on USMLE means that this person will be a better doctor than someone with a lower score and then you make the point... well I would rather have a person who scored higher than a person who barely based as my doctor (maybe even if they were a**hole). Tests aren't everything. Maybe I'm a little biased towards this subject, but that's my opinion. If I ever get to a point of being on a residency committee, I wouldn't give USMLE as much weight as others.

 

[Frugal Traveler]

So my original post was to make the point that they take many variables into consideration. I forgot to mention cronyism as well... like if you know someone or you did an AI there. The bottom line is that many things are taken into account.

I've talked to 3 program directors at my school in various specialties, and USMLE score is helpful for knowing the applicant will not fail the ABSITE, ABIM, or whatever else exam you have to take... USMLE is the great equalizer (as are shelf scores if they are on your MSPE)... because we all know grade inflation is rampant! The class ranking on the MSPE is also useful (it's like a USMLE report for your school). A program director might be concerned if you are in the bottom third of your class.

The USMLE score does not indicate clinical prowess... that is what the third year clerkship grades are for ("street smarts" and convincing people you can at least show up every day on time and put forth effort) ... I'd be more concerned if a person had a bad performance in third year clerkship than a bad Step score.

If I had applicants with equal Step scores and grades, I would pick one applicant over the other if:
- applicant 1 went to a better school
- applicant 2 who went to a lower ranked school was much more sociable and would get along with the residents
- applicant 2 was from Alaska or some geographical area/ or could bring diversity somehow to the program (speak Mandarin, non-traditional applicant, other random stuff).
- applicant 2's program director or someone influential called me and said that he/she was the best thing since sliced bread.

However, I would take less stock in getting along with the residents because I do not think the interview is stressful enough to bring out annoying/bad characteristics of an applicant. Approximately 5 % of applicants will make a fatal mistake and not get ranked because their behavior on interview days because most people can keep it together.

Plus, not every program is inviting you because of your outstanding stats... I believe there is such a thing as "safety invites" to get a certain "critical mass" so they do not have to scramble. It would vary by program. Remember programs do not always rank everyone!!!

 

[drtt2bear]

I've been told differently by all 4 PDs and GME directors that I've interviewed with thus far. I asked them the same questions and they keep telling me your scores got you an interview, but we want to find out how well you fit in with our residents and our program-- because we don't want to work with an ******* over the next few years.

This isn't medical school anymore-- it's a real job. You will be working one-on-one with the team that's already in place. If you are a dick, but your scores are really high, you won't get the spot. One caveat, there may be some specialties where being a dick is the norm. You might get a spot there.

Dittos to the above. I too have heard the same things from more than 4 PDs and several residents I spoke with. When one gets an interview, one is one equal footing with all other applicants. So if you have very high scores and the PD in the interview does not find you likeable, and the residents don't see you as a team player, then you will lose the spot to another applicant with lower scores who is immediately likeable, personable, and seen as a team player. Who wants to spend 3-4 years working day and night with a smart and intelligent jerk?

 

[Sophie]

Dittos to the above. I too have heard the same things from more than 4 PDs and several residents I spoke with. When one gets an interview, one is one equal footing with all other applicants. So if you have very high scores and the PD in the interview does not find you likeable, and the residents don't see you as a team player, then you will lose the spot to another applicant with lower scores who is immediately likeable, personable, and seen as a team player. Who wants to spend 3-4 years working day and night with a smart and intelligent jerk?

I've heard this a lot too.

I took a quick look at First Aid for the Match a few weeks ago and was surprised to see a little box that listed the top 5 things residency directors were looking for. What shocked me most was that academics was listed as #4. The other items were all personality traits, such as maturity, personable, hard-working, motivated/dedicated, or something like that.
(Quick warning: I can't remember exactly what the book said, so I might be totally butchering this... if someone has the book and I'm wrong, please correct me)

I really believe we all think Step 1 scores are way more important than PDs do.

 

[fever106]

I've heard this a lot too.

I took a quick look at First Aid for the Match a few weeks ago and was surprised to see a little box that listed the top 5 things residency directors were looking for. What shocked me most was that academics was listed as #4. The other items were all personality traits, such as maturity, personable, hard-working, motivated/dedicated, or something like that.
(Quick warning: I can't remember exactly what the book said, so I might be totally butchering this... if someone has the book and I'm wrong, please correct me)

I really believe we all think Step 1 scores are way more important than PDs do.

I am not minimizing the importance of the interview. However, I do not believe that 200-300 people with different scores, different letters, and different experiences are all on equal footing and that the interview alone makes the decision of who gets ranked where. You have different people doing the interviews on different days, and one person may love an applicant, while another interviewer might have been luke warm. The other variables must continue to play a role in the decision. PDs are likely to tell applicants that the interview is the be all end all because they want applicants to take it seriously, have hope, and put their best foot forward, even if they are less than stellar in other areas. I looked at the match list from my school from last year. The people who matched in the most competetive specialties and in the best programs were either AOA and/or had excellent scores. The I knew many of them, and some did not have the best personalities and were not the most easy to get along with, but they still matched at the top programs. I also knew many people who were great individuals, but lousy test takers, and not a single one of them matched really high. There is a consistent pattern here, and it does not suggest that everyone who gets an interview somewhere, ie their foot in the door, is miraculously placed on equal footing until the interviewer spends 30 min with you.

 

[ResidentMD]

I am not minimizing the importance of the interview. However, I do not believe that 200-300 people with different scores, different letters, and different experiences are all on equal footing and that the interview alone makes the decision of who gets ranked where. You have different people doing the interviews on different days, and one person may love an applicant, while another interviewer might have been luke warm. The other variables must continue to play a role in the decision. PDs are likely to tell applicants that the interview is the be all end all because they want applicants to take it seriously, have hope, and put their best foot forward, even if they are less than stellar in other areas. I looked at the match list from my school from last year. The people who matched in the most competetive specialties and in the best programs were either AOA and/or had excellent scores. The I knew many of them, and some did not have the best personalities and were not the most easy to get along with, but they still matched at the top programs. I also knew many people who were great individuals, but lousy test takers, and not a single one of them matched really high. There is a consistent pattern here, and it does not suggest that everyone who gets an interview somewhere, ie their foot in the door, is miraculously placed on equal footing until the interviewer spends 30 min with you.

I think most people have got it right.

Two points-

1. I dont think there is an agreement between people on whether there is a pre-interview ROL for programs versus those on equal footing. I have heard both versions of the story. Frankly, I dont think that would make a difference. Tomorrow, if Brighams calls you and you are 249/250 on their pre-interview ROL, will you reject their invite? Will you "not be at your best"? So I think this discussion is moot. I think when you have an interview, it just means, if you want to go to that place, do your best.

2. Regarding the person who ranted - do you really think more than two people will have the SAME letters, research, blah blah? Come on. The only thing similar I can think of are the scores. Then its all subjective regarding why they choose you. How well you fit into the program especially. I dont think there is a single PD out there that makes his ROL on scores alone, and will rank one equally personable candidate above another just because of his scores. THere are many, many factors that go into it - Frugal mentioned a few.

 

[Frugal Traveler]

My personal feeling is that many programs have a gross ROL... but meeting someone in person is so important... that's why a program typically has a ROL meeting in February with our lovely ERAS pictures. I think if you show up, and they sense you are a genuine person, then you get huge points for that because you cannot fake that.

A program is going to use any and all data they have available to make sure they have winners in their program. Offering someone a job for 3 to 5 years is a HUGE DEAL (although the contract typically renews yearly).

I don't subscribe to the equal footing theory once you get an interview. They know they need a certain number of invites to avoid the attrition that will occur due to people canceling late and a certain safety number to fill their rank list. If you look at the matches are certain programs, they tend to be from the same schools. If I was running a program and we had more than two duds from a certain school, I would tend to subsequently avoid that school (because maybe someone spastic took over the medical school adcom).

If you look at certain specialties, the AOA and USMLE numbers are crazy high (like dermatology, plastics, and neurosurgery) such that statistical variation would not account for it (and guess what... it correlates to the most competitive specialties logically)... these people may be absolute dicks in their personal lives, but such programs are looking for exceptional applicants and these people are clearly smart enough to put on a great show on interview day. We all know what happens when the contract is signed... they turn back to whence they originally were. I've heard rumors that USMLE Step 1 needs to be around 240 for top derm (have no confirmation on this... but wouldn't doubt it for places like UPenn, the king of derm publications).

All in all, go to the programs, interview, and rank as you please... that's the way to have a successful match. Lots of great opportunities out there for almost everyone... so be positive and have fun during MS4... you may just be what the program was looking for despite all these factors we debate 🙂

 

[synapse lapse]

I've heard rumors that USMLE Step 1 needs to be around 240 for top derm (have no confirmation on this... but wouldn't doubt it for places like UPenn, the king of derm publications).

Much higher than that I'm sure, the average step 1 for matched derm overall was 242 last year (NRMP charting outcomes). In any case, I doubt you are on equal footing during your interview, I am almost positive most programs have a pre-interview ROL that is probably not set in stone, but has some rough tiers. I got an invite off a waitlist today and while obviously I'm going to do my best (would really love to match at this place) I don't think my statistical chances of matching there are as good as someone who got invited from the get go. It seems obvious that a good interview will move you up from your pre-interview position though, so you shouldn't decline interviews for preconceived notions of where you are on their hypothetical rank list. One PD I talked to said that when making their final ROL they use 5 main criteria which are scored, and 2 of those are directly related to the interview day.

 

[Gentle]

Much higher than that I'm sure, the average step 1 for matched derm overall was 242 last year (NRMP charting outcomes). In any case, I doubt you are on equal footing during your interview, I am almost positive most programs have a pre-interview ROL that is probably not set in stone, but has some rough tiers. I got an invite off a waitlist today and while obviously I'm going to do my best (would really love to match at this place) I don't think my statistical chances of matching there are as good as someone who got invited from the get go. It seems obvious that a good interview will move you up from your pre-interview position though, so you shouldn't decline interviews for preconceived notions of where you are on their hypothetical rank list. One PD I talked to said that when making their final ROL they use 5 main criteria which are scored, and 2 of those are directly related to the interview day.

So I'm deviating from the OPs post but just want to understand this: How do you know that you're placed on a waitlist?? Does the program e-mail you and inform you that you're being placed on their waitlist? One GS program offered me an interview and when I asked if they had alternate dates, from the one offered to me, they told me that they have 1 alternate date wh/ is full and could place me on their wait list for that date.

-Gentle-

 

[synapse lapse]

So I'm deviating from the OPs post but just want to understand this: How do you know that you're placed on a waitlist?? Does the program e-mail you and inform you that you're being placed on their waitlist? One GS program offered me an interview and when I asked if they had alternate dates, from the one offered to me, they told me that they have 1 alternate date wh/ is full and could place me on their wait list for that date.

-Gentle-

Deduced from the fact that they only gave me 1 date, and said they sent out 2 invites when I called. They didn't explicitly tell me I was off a waitlist.

 

[hanjoko]

I dont think there is an agreement between people on whether there is a pre-interview ROL for programs versus those on equal footing. I have heard both versions of the story. Frankly, I dont think that would make a difference. Tomorrow, if Brighams calls you and you are 249/250 on their pre-interview ROL, will you reject their invite? Will you "not be at your best"? So I think this discussion is moot. I think when you have an interview, it just means, if you want to go to that place, do your best.

In this case, then, I wonder if the above is the truth, does it mean that it is possible for the following hypothetical scenario?

Suppose you get invites from program A,B,C,D,E.

pre-interview ROL at program A,B,C,D: 249/250 (all 4 are very competitive programs)
pre-interview ROL at program E: 20/250 (not as competitive as A,B,C,D)

You did equally well in all 5 programs but because of the pre-interview ROL, you move from 249/250 to 230/250 for programs A/B/C/D and from 20/250 to 10/250 for program E.

Suppose you submit your own rank list with 1st) A, 2nd) B, 3rd) C, 4th) D, and 5th) E. You will end up matching in E because even though you move up on the ROL for rograms A/B/C/D, it does not really matter in the end because your pre-interview ROL is way too low...?

Also, in this case, having all those 4 interviews will actually give you a false sense of security (for how competitive you are) because in the end, you will match into E....?

Not sure if I am reading too much into this...I guess it doesn't really matter for us applicants since there is no way to know if there is a pre-interview ROL or where we stand on that ROL. In any case, you would still accept those interview invites anyway.

 

[synapse lapse]

In this case, then, I wonder if the above is the truth, does it mean that it is possible for the following hypothetical scenario?

Suppose you get invites from program A,B,C,D,E.

pre-interview ROL at program A,B,C,D: 249/250 (all 4 are very competitive programs)
pre-interview ROL at program E: 20/250 (not as competitive as A,B,C,D)

You did equally well in all 5 programs but because of the pre-interview ROL, you move from 249/250 to 230/250 for programs A/B/C/D and from 20/250 to 10/250 for program E.

Suppose you submit your own rank list with 1st) A, 2nd) B, 3rd) C, 4th) D, and 5th) E. You will end up matching in E because even though you move up on the ROL for rograms A/B/C/D, it does not really matter in the end because your pre-interview ROL is way too low...?

Also, in this case, having all those 4 interviews will actually give you a false sense of security (for how competitive you are) because in the end, you will match into E....?

Not sure if I am reading too much into this...I guess it doesn't really matter for us applicants since there is no way to know if there is a pre-interview ROL or where we stand on that ROL. In any case, you would still accept those interview invites anyway.

Precisely.

 

[NotAProgDirector]

After all, if you passed the steps (designed for competency evaluation) you will likely pass the boards, and that is basically the only number programs care about.

This statement is not true. The only people who get to take "the boards" are those who have already passed the steps, and not everyone passes the boards. In my experience, it is clearly those with lower end step scores who struggle with the boards.

The question is, if everything else is equal (i.e. clinical grades, great LORs, publishing, research, volunteering) between two applicants and the ONLY thing that is different is one has a good score (lets say 220) and the other has a slightly subpar score (lets say 205-210). Why is the applicant with automatically a "better" applicant and might get a chance at an interview over the first applicant.

If the two candidates are exactly identical in all ways except for their step scores, and I only have 1 interview to offer, exactly how should I decide whom to give it to? (others have made the point that your "thought experiment" isn't realistic since there are so many differences inherent in people's apps)

When one gets an interview, one is one equal footing with all other applicants.

This probably depends on the size of the program. For small programs trying to match only a handful of residents, then fit become vital. For larger programs it's much less under control, and PD's are likely to use objective criteria (like step scores and clinical performance) to build a rank list that is 200-300 people long.