I heard its better to rank acoording to...

[sweetfynesse]

I've heard from some younger EM attendings and EM residents that it is best to match at a program that ranks you at the top of their list than at a program where you're at the middle or bottom of their list. And that it's better to go with a program that actively recruits you than one that is lukewarm or doesn't contact you.

I thought that was ridiculous until I questioned a few other residents, even in other fields, and they said the same thing. What do you guys think?....What if you knew you were ranked 40 on the list of your number 1, and that they usually only do down as far as 23 during match? Would you still rank them #1? Or, would you feel like they really didn't want you?

Personally, I used to think one should just rank according to which programs they like the most, and not according to how a program thinks of them. Now, I'm not so sure...As for my rank list, I am just going with my gut, and trying not to put too much stock in post-interview communication, although it may have subconsciously altered my top 3 programs...

---

Members don't see this ad.

 

[DrQuinn]

Good question, and one that hasn't been brought up in the recent past...

It behooves you to rank your #1 as the program YOU want, regardless of where you "believe" that you may rest on their rank list.

Since the NRMP is based on the "applicant-preferred" algorithm, compared to when the residencies had the priority, there is no difference if you are 2nd on their list or 34th. If you rank University of BlackCat as #1, you are ranked #69, and you match with them for whateve reason, well, then you match. If you rank them #6 because you believe you are unlucky #69 or lucky #1, it won't matter, as likely you will have ranked earlier up.

If your #1 rank does not even rank you, then your #2 rank BECOMES your #1 list and you start over.

I would suggest NEVER EVER to rank a place based on where you perceive your position on their rank list. If it ever came down to you matching with them, it should be lower on your list (if that's the only reason they're high on your list anyways).

Confusing but it makes sense if you read the NRMP website.
Q

 

[md-student]

What were you told was the reason that it's best to match in a place that ranks you high rather than low? Is it because of liklihood of matching or does it have something to do with the way the program will treat you once you get there?

As QuinnNSU points out, the algorithm works the way it works and you should rank according to preference to get the best match. But, if there you've been told low ranked candidates are treated poorly following the match because the program really didn't want them, then that's another story. Though I highly doubt that if a program didn't want you that they would bother ranking you, unless filling is that important to them that they rank undesirable candidates.

 

[sweetfynesse]

QuinnNSU and md-student,

Thanks for your replies.

I totally understand the match algorithm. Interesting enough, QuinnNSU, I used that same argument with my attending. Yet, he maintained a point that is primarily based on the idea brought up by md-student. He feels that one will be treated differently because they weren't highly sought after or recruited if they're not at the top of the rank list. I thought that was ridiculous. I can't imagine PDs, or faculty, treating their residents different based on their ranking order.

 

[blackcat]

sweetfynesse - that is ridiculous!
why would they treat you any differently? they interviewed you, they ranked you, and they need you to do the work! just because you rank a program highly doesn't mean you take a more sought out applicant's spot. it makes no sense to me.
all that ranking system would accomplish is to stroke your ego by going to your number one and stroke theirs by having them not have to go that far down the list.

quinn- thanks for naming the u after me. i knew all that money would do good somewhere. i just thought you would name the library after me.

rank them how you'd want to go there. also, you never even know if the programs really want you. i think the nrmp site gives good examples of why you need to rank the programs on your desire, not the programs.

my 2/5's of a nickle!

 

[DrQuinn]

I will agree with Blackcat, this is probably just a single attending's opinion of it... this is just a ridiculous rumor. Blow it off.
Q

FOUR WEEKS UNTIL MATCH DAY!!!!!!!!!!!!!

 

[The White Coat Investor]

Please don't post things that encourage applicants and PDs to continue to play this stupid post-interview communication game. This match would work best if all program directors would just say what Arizona, UC-Davis, Indiana and numerous other directors tell you: "We won't initiate contact with you after today." Who cares if they have to go way down their match list? No one. Let the programs rank us in the order they want us and we'll do the same. All this "You'll be ranked very competitively" B.S. ought to stop. It just encourages everybody to lie and/or spend money and time making phone calls, sending letters, sending christmas presents etc. I know of no bigger turn-off to me than a program director calling me at home in the evening pretending to ask if I have any questions about his program when he is really just trying to figure out where I ranked his program or trying to get me to move it up my list. One of the most uncomfortable interviews I had was with a program director who spent the whole interview trying to figure out how serious I was about his program, and this was before I ever even took the tour! I'll get down off my soap box now.

 

[Apollyon]

Originally posted by Desperado
I know of no bigger turn-off to me than a program director calling me at home in the evening pretending to ask if I have any questions about his program when he is really just trying to figure out where I ranked his program or trying to get me to move it up my list.

I have not been troubled by such things.

The first three places I interviewed at didn't even ask where else I had been or was going to.

 

[codebrown]

Agreed- And then there were the program directors who sat you down and asked you to list everywhere else you were interviewing. One PD didn't accept my general answer and kept encouraging me to list one program after another, taking notes the whole time. I wonder if they do this to compare how competitive _they_ are. Or maybe they do it to make deals with each other.... Has anyone heard of this sort of thing going on between PDs?

 

[md-student]

I'm not doing EM, but the same thing happened to me.

On one interview, I was asked which places I was applying to. I tried to be vague, but he kept pushing me to tell him every one. Then he proceeded to try and get me to tell him everything that I liked and disliked about each one. That was the entire interview with this guy. No, "do you have any questions?", "why would like to come here?"

 

[edinOH]

I agree completely! This whole "I love you, you love me" game is a load of crap.

I'm sure that my number one choice will rank me high. I think the fact that I sent the PD a case of single malt scotch will have absolutely no bearing. If my first choice doesn't work then I'm sure me and the PD at my second choice will have plenty of time next year to enjoy the box of cuban cigars I sent him. Now if I really suck and end up with my THIRD choice, I'm definitely not going to share with the PD that ***** I bought...wait, nevermind.


It's all good. Thankfully we only have to go through this once. (I hope)

 

[nychick]

I'm not doing EM either, and I'm an IMG, so I had the added dimension of a potential pre-match, which can be a blessing or total hell. [I had a very happy ending tough cuase I ended up at the place I would have ranked no 1 if I had had to make a ROL).

So one PD, after offering me a pre-match slot, asked me if I had received any similar offers, and where, and where else I was interviewing. He gave me a 2 hour tour of the hospital and proceeded to bad-mouth the program that I had an offer from as well as every other place in town--it made me really uncomfortable, and was actually a terrible turn-off.

I figured if he rants like that to me, an applicant who he's just met, what does he do when you're working there--badmouth you behind your back? It was kind of the reverse of the PD asking md-student to say bad things about the programs s/he'd been at.

The whole thing is just so warped in so many ways. I mean, you never know, this **** can get so political. In the end, the whole thing reflected worse on the PD and his program than if he had just shut up about it all. And then, when I spoke to him later to tell him I wasn't going to go there but the other place, he did it again!

 

[edinOH]

nychick,

I'm not sure I follow. Do you mind explaining that again?

Just kidding.

 

[nychick]

it got posted many times cause there was a hangup with the site. My bad.

 

[bcrosspac]

I am curious about the positions offered to applicants outside of the match. I thought that even if you are an independent applicant (IMG, osteopathic, etc), you must abide by the NRMP rules and go through the match. Is this not the case? I will be an osteopathic applicant next year. Can programs offer me a position outside of the match? Info would be appreciated.

 

[Annette]

From 2004 on, if a program is going to participate in the match, then they have to offer all positions in the match. In effect, everyone will have to go through the match. There may be a few places that choose not to use the match, but I expect that they will mainly be those that already fill with pre-match applicants. This is the last year "independent applicants" may go outside the match. I don't know about DO students, but the definition of "independent applicant" can be found on the NMRP site

 

[DrQuinn]

Originally posted by bcrosspac
I am curious about the positions offered to applicants outside of the match. I thought that even if you are an independent applicant (IMG, osteopathic, etc), you must abide by the NRMP rules and go through the match. Is this not the case? I will be an osteopathic applicant next year. Can programs offer me a position outside of the match? Info would be appreciated.

bcross-
As an osteopathic applicant myself (read: Independent), this year was the last year of huzzah. For the year 2004, there will be no acceptances outside the match for ANY residencies, be it IM/Surg/or EM. You will be on the same level as an MD applicant. Which sucks for you but hwat the hay. I've had a few EM PD's ask em for spots outside the match (which I declined) but in general most abide by the match rules, which is fine by me (I really shouldn't be ranked above such studs as MikeCWRU, JPGreer, Blackcat (especially), Apollyon, Hornet, etc).


As a DO applicant. you have ot push yourself above and beyond. Background experience doesn't help much. PUSH YOURSELF, dammit. That's the only way to get interviews (also, dont' limit yourself).
Q

 

[blackcat]

why do i deserve to be included in the stud category?
i am no such thing/person!

 

[Annette]

Quinn, just because you are an independent applicant doesn't mean that you are above or below US about to be MD grads. Because of the way you act, you are way above! (Thanks for trying to set me up with interviews!)

IMHO, the ability to pre-match helped to level the playing field. Now, independent applicants will have to compete head to head, often with significant biases against them.

 

[DrQuinn]

Thanks for the kind words, Annette...

I do agree that there should be no signing outside the match, even though I had the opportunity too (and I have friends in my class who did, although none in EM). You're right, it SHOULD be a level playing field for ALL spots.

Guess what? We have... 25 days until Match Day!!
Q

 

[jpgreer13]

Whoa. A stud, moi?

I think that must've been the Heineken talking!

But seriously folks, I think the whole ROL certification day business should be moved a lot closer to Match Day, or Match Day should be moved a lot closer to February 26th. Because I know now that the programs' lists are due the same day ours are, and I know it doesn't take a computer almost a full month to run that algorithm. And although I try to say, well, it's out of my hands now, and try to not think about it, that's a lot easier said than done!

 

[endo]

Maybe they're running it on a Commodore 64.

 

[Annette]

I heard (not always a good sign ) that they run the program from multiple starting points to try and get they highest number of happy campers. Still, I think that they really just secretely like to torture us poor applicants.

 

[codebrown]

I had heard that too- not that they run it to get the max number of happy people, but that they run it multiple times, starting with different people to make sure that the results are the same every time.

Can anyone figure out why things would be different if you start with person A instead of person B? If both ranked "City" hospital number one, and "City" ranked A above B, then B would always get bumped no matter if you began with A or with B...
I think that the results wouyld always be the same no matter where you began- maybe running it several times is just quality control.

Also- has anyone ever heard of an applicant's ROL getting lost in the system. Submitted, but not included. Or if programs misspelled an applicant's name and ranked the wrong applicant...


...just following up on a night of bad dreams ;(

 

[mikecwru]

Originally posted by codebrown
I had heard that too- not that they run it to get the max number of happy people, but that they run it multiple times, starting with different people to make sure that the results are the same every time.

Can anyone figure out why things would be different if you start with person A instead of person B? If both ranked "City" hospital number one, and "City" ranked A above B, then B would always get bumped no matter if you began with A or with B...
I think that the results wouyld always be the same no matter where you began- maybe running it several times is just quality control.

Also- has anyone ever heard of an applicant's ROL getting lost in the system. Submitted, but not included. Or if programs misspelled an applicant's name and ranked the wrong applicant...


...just following up on a night of bad dreams ;(

I would assume that the program's rank you by ERAS #, not name. That's probably the error control for ranking the wrong person.

I know that there is another <my name> out there applying to emergency medicine. Kind of weird.

mike

 

[jpgreer13]

You know, I HAD a Commodore 64, and it could've probably run that algorithm in less than 24 hours, even as slow as it was.

You've got to figure it might take an industrial-strength computer an hour tops to run that list once, and I'm being generous here. They could do triple digit numbers of iterations of the algorithm in a week or two. Why then does it require 22 days of grueling torture to get this result?

Of course, the result I'm REALLY interested in is that phone call BEFORE the match from the dean. If I don't get THAT call, I'll be MUCH less nervous those last few hours.

 

[DrQuinn]

The DO Match, which uses the "National Matching Service", is very similar to the MD Match, the NRMP. The DO Match STILL takes about a month or so after the ROL are due... and the DO Match has far far far far fewer # of applicants... Let's say 80 per school x 20 schools = 1600 applicants, compared to the oodles of MD/FMG/DO applicants for the NRMP...

One could do the 1600 by hand (although I wouldnt' want to) in a few days or so... yet it still takes the DO System a month...

DAMN YOU!

I'm more worried about the Monday than the Thursday. Although I am debating whether or not to rank one program at my last spot, as I did one rotation there and they have contacted me via the phone/email... I just... really dont' want to go there....
Q

 

[Annette]

Quinn, would you rather go to that program, or scramble and possibly NOT get an EM spot? I think the advice to not rank a program works well for specialties that usually have alot of unfilled spots. Chances are then that you will find a place that you would like better than the place you didn't want to go to. However, in specialties that don't have a lot of unfilled spots, if you definately want that particular specialty, you are better off to rank a program you wouldn't really want to go to rather than risk not getting into that specialty at all. In your particular case, with PD's offering you prematches, I seriously doubt that you would end up at your last ranked program.

As far as the matching taking so long, I think the delay is probably due to the time needed for the statisticians to review everything (depsite my previously proposed torture theory). They run the match multiple times starting from different points because the starting point can make a difference. I know the theory, theoretically, but can't quite pull the whole thing out of the back of my brain right now. Damn statistician's block. However, if anyone is interested in it, check a stat book for step-wise analysis (step forward, step back- where they either start with all the variables and eliminate them one by one or where they start with no variables and add them in one at a time.)

 

[doctim]

Of course, the result I'm REALLY interested in is that phone call BEFORE the match from the dean. If I don't get THAT call, I'll be MUCH less nervous those last few hours. [/B][/QUOTE]

does this (the phone call) really happen often? and if you did not get that call, wouldn't you be MORE nervous

peace

 

[blackcat]

doctim - the phone call means you did not match and you have to scramble. if you don't get a phone call, you have matched and you have nothing to worry about. assuming that you did what everyone said and only rank places you wanted to go to.

 

[doctim]

ahhhhhh...sorry ... phone call = bad
as an IMG, i would never receive a phone call from my dean
that's good news

peace, thanks, and good luck

 

[Apollyon]

Originally posted by jpgreer13
You know, I HAD a Commodore 64, and it could've probably run that algorithm in less than 24 hours, even as slow as it was.

You've got to figure it might take an industrial-strength computer an hour tops to run that list once, and I'm being generous here. They could do triple digit numbers of iterations of the algorithm in a week or two. Why then does it require 22 days of grueling torture to get this result?

Ken Iserson (in his book on residency) said that the ENTIRE match program runs in about 6 minutes. Not 60, 6.

Why does it take so long? Because the whole medical administration is just a bureaucratic morass. I had the extra fun of the extra steps that the ECFMG throws down in front - "you forgot this, oh, it took us three months, you fixed it in one day, back to the end of the line!" (<-- true story). It DOESN'T require 3 weeks - it's just a boondoggle on the part of the AAMC/NRMP/AMA.

 

[Hornet871]

Is the infamous "call from the dean" the only way for AMGs to find out that we didn't match?

My friends who applied last year said that they just logged in to the NRMP site on Unmatch Day (Monday). A message there read: "Congratulations, you have matched," but didn't say where. Then on Match Day (Thursday) they found out, as per tradition.

Thing is, these friends were IMGs, so they have no dean's office to hook them up (i.e., screw them over).

Can we AMGs also log in to the NRMP site on Monday, 3/17 to find out if we matched?

I'm supercurious because I'm out of town and won't be back till the night before Match Day, so my dean can call all morning and I'll never hear from him.

What should I do?

 

[mikecwru]

(from the web site)

Matched or Unmatched Information

Beginning at 12:00 PM EST on Monday of Match Week, applicants can log on to the NRMP web site to find out whether they are matched or unmatched. The appropriate message is displayed on the Applicant Options page. E-mail notifications also are sent to applicants.

 

[DrQuinn]

MikeCWRU to the rescue... phew-wee!
Q

 

[jpgreer13]

This...has made my day.

Now I will have THREE FULL DAYS of peace of mind before Match Day. Either that, or three full days of weeping and wailing and gnashing of teeth...but we'll not get into that. My best friend in med school was matching in ophtho and got the bad touch, and seeing that has just chilled my enthusiasm for my own match. I realize that EM isn't quite as bad as ophtho, and he did only rank six places, but it's like getting Ebola or something...it's not scary until it happens to someone you know.