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Old&InTheWay

Old&InTheWay

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So I received an email from a PD at one of the programs I interviewed at saying I was their top choice for their combined 5yr child track and that I was guaranteed to match there if I wish to. The weird thing is that I didn't ever actually apply to the child track. I didn't apply to any combined programs as I've been on the fence about whether I want to do child (and I continue to be on the fence). I do have genuine interest in child psychiatry (along with some professional background in working with various ilks of troubled youth), and I talked about all of this at every program I interviewed at, but I always couched it in the uncertainty I have as to whether it's the field I ultimately want to pursue (as I have many other interests).

This program was high on my rank list (before the email) and I would love to go there. And it sounds like I could go no further down my list if I rank the combined program. I do think I could benefit from the increased exposure to child psychiatry but I could easily see myself deciding next year or the year after that I don't want to do a child fellowship. And I think I might feel kind of guilty taking a combined spot away from someone else who definitely wants it (or is more certain).

The PD also said in their email that I would be ranked highly, but did not explicitly say I was ranked to match, for the general psych program.

So do I rank the general program followed immediately by the combined program in order to maximize my chances to matching here but knowing that I may back out? I kind of want to talk with the PD first and let them know what I am thinking in the spirit of transparency...is this crazy? Or do I just rank the general program and see where the chips fall?
 
I don’t have anything great to add, but this would be a more funny take on the traditional story where the resident says they ranked it #1 then matched elsewhere. Instead, if someone in this scenario said they ranked it #1 (the child spot), then matched into the general program, that could be awkward.
 
michaelrack said:
I am far removed from residency, but wouldn't that email be proof of a match violation by the program?
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Not unless they are asking about his ranking of them or suggesting a quid pro quo. It's a tad smarmy but not a violation per se, they can volunteer whatever information they want to offer.
 
Agreed on just rank in order of your preference. I'm 95% certain I know which program you're referring to (I received a similar email last night, too) and their CAP program is new (maybe 4 years worth?). If I recall correctly, 2 residents who were combined have dropped CAP entirely, while another ended up applying and matching elsewhere.

So they seem flexible, in case you DO end up matching their CAP program and then decide to explore other CAP programs/not do CAP at all.
 
autopoietic said:
Agreed on just rank in order of your preference. I'm 95% certain I know which program you're referring to (I received a similar email last night, too) and their CAP program is new (maybe 4 years worth?). If I recall correctly, 2 residents who were combined have dropped CAP entirely, while another ended up applying and matching elsewhere.

So they seem flexible, in case you DO end up matching their CAP program and then decide to explore other CAP programs/not do CAP at all.
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Oh awk they’re sending that email to everyone..lol
 
Do not be pushed into the 5 year program if you are unsure. Do rank them for what you interviewed for, but this behavior would probably take them down a few in my opinion. Kind of tacky I would say.
 
This is business. The PD is doing marketing. This is not dating and its not emotions of the heart with real people-to-people connections. You are a widget and they want the best widgets to make their factory churn. Until the match is done, and you have truly started on July 1. On that day you become a person, a real human being integrated into the human resource machine.

Ignore the email and make your rank list how you want it.
 
Thanks for all the advice...just needed to have some sense talked into me.
 
whopper said:
The PD might've called you thinking you were a different candidate.
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That's what I thought at first, but I don't think so...the email was so personal with a lot of details of my background.
 
Or keeping people in them. Hopefully most programs rarely have to fill openings, but when they do, the best people come from combined programs that want out. At least they have a reason to want out other than "my program sucks".
 
I'm not going to name the program but I do know of one where it's a combined general and fellowship program where some applicants figured out to apply into it and their odds of getting in were higher than just doing regular general psych.

And while in the combined program, after a few months just drop out of the combined program and then get into the general program saying they decided to have a career change. What really ticked me off about this was the PD is one of the top guys in the field, is a genuinely caring physician, a great teacher, and a great human being. It was a major disservice to him for these people to use this as a way to sneak into general psych. Someone I knew was going to apply into the combined program as a sneak-in and I got ticked off saying it was disrespectful to the PD to pose off as if you care about that fellowship when in fact you don't have any interest.

From what I wrote you can pretty much figure out the fellowship program that was not very popular. It wasn't cause of the PD. It was cause of the field-geriatrics. Seems most people don't have an interest in it despite that it is in great need.
 
whopper said:
I'm not going to name the program but I do know of one where it's a combined general and fellowship program where some applicants figured out to apply into it and their odds of getting in were higher than just doing regular general psych.

And while in the combined program, after a few months just drop out of the combined program and then get into the general program saying they decided to have a career change. What really ticked me off about this was the PD is one of the top guys in the field, is a genuinely caring physician, a great teacher, and a great human being. It was a major disservice to him for these people to use this as a way to sneak into general psych. Someone I knew was going to apply into the combined program as a sneak-in and I got ticked off saying it was disrespectful to the PD to pose off as if you care about that fellowship when in fact you don't have any interest.

From what I wrote you can pretty much figure out the fellowship program that was not very popular. It wasn't cause of the PD. It was cause of the field-geriatrics. Seems most people don't have an interest in it despite that it is in great need.
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So in your view, do you think I should reach out to the PD to let them know where I am at and what I am thinking? Or just rank my preferences with the combined CAP program lower in my list (because I would certainly rather match into the CAP program than not at all).

I hate that the match is treated as sort of weird game where social/ethical norms are ignored. I kind of feel like honest, open communication throughout this process would actually lead to better matches for programs and applicants.
 
IMHO, I don't think emails like that are good faith emails. They're coming from a position of power and at some level folks know that it exerts some pressure on you.
I see it as full license to play the game however you want to. If you want to call this poker, they showed their hand without anyone asking them to.

You have no idea if they're full of crap. This happens all the time where a PD calls or sends a message like this and the applicant doesn't match there even after changing their list.

F that noise.
 
This is high stakes on both sides and ridethecliche's poker analogy is spot on. PDs who do this are showing their hand both in terms of their list intensions and in terms of their flawed moral compass in my opinion. Don't underestimate the value of integrity in your future mentors. NRMP rule specifically outlaw quid pro quos and this sounds like an "if you rank our 5 year program, then.... "
 
MacDonaldTriad said:
This is high stakes on both sides and ridethecliche's poker analogy is spot on. PDs who do this are showing their hand both in terms of their list intensions and in terms of their flawed moral compass in my opinion. Don't underestimate the value of integrity in your future mentors. NRMP rule specifically outlaw quid pro quos and this sounds like an "if you rank our 5 year program, then.... "
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Yeah, it was nothing like a quid pro quo. And I don't think it's terribly wrong for PDs to try to court applicants they want (just like a regular employer might)...as long as they are being honest. I don't see the connection between someone saying "we think you would be a great fit and would love to have you" and a flawed moral compass. That said, I totally agree with the idea that we shouldn't allow these types of communications to significantly influence our rankings. My particular struggle was that it introduced a new rank option to my equation.

I do not agree with the poker analogy; this is not a zero sum game. Applicants and programs both "win" when applicants are matched at programs to which they are well suited and will thrive. Integrity will not magically arise from everyone continuing to consider this process a "game" in which social and ethical norms do not apply.
 
You were the one reading the communication so if you say it was normal solicitation, I stand corrected. The real slippery slope is that if a program has 4 slots, they can ethically play this game with 4 people, or 8 slots, 8 people. There will always be stories where applicants feel promised something that doesn't happen because directors can stretch things a little further. I would agree that no one fills 8 slots with their top 8 people, but the flip side is that no director can predict what will happen so they shouldn't play that game.
 
Understand that physicians are people at the end of the day. They may be more intelligent than the average population, but that doesn't mean they are more moral or more honest than the average population. There absolutely are PDs who will bend the truth, if not straight out lie, to advance their own agenda. They don't do what is right, but what they won't get in trouble for. Take everything they say with a grain of salt until the contract is signed.

It's a good lesson to learn early on. The only person who can protect your interest is yourself. Trust is not given, it is earned.

Just rank as you normally would and don't factor what they say into the equation.
 
MacDonaldTriad said:
This is high stakes on both sides and ridethecliche's poker analogy is spot on. PDs who do this are showing their hand both in terms of their list intensions and in terms of their flawed moral compass in my opinion. Don't underestimate the value of integrity in your future mentors. NRMP rule specifically outlaw quid pro quos and this sounds like an "if you rank our 5 year program, then.... "
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I wouldn't go as far as the flawed moral compass thing, but I think the thing to remember is that they can say anything they really want to and they're not going to be held liable to it. There are tons of reports in fields where folks are told all sorts of things and they rank that program first and then don't match there. I'm just saying that there's nothing binding about any of this communication so it should just be taken as a nice pat on the back and no thought should be given to it. The only action you take should be to respond with humility and tell them that you loved their program and would love to go there.

You could also tell them that your administration has said that you weren't allowed to do any sort of post interview communication because that's what the NRMP says and that you're really grateful that they reached out but you're really not allowed to say anything else.

Old&InTheWay said:
Yeah, it was nothing like a quid pro quo. And I don't think it's terribly wrong for PDs to try to court applicants they want (just like a regular employer might)...as long as they are being honest. I don't see the connection between someone saying "we think you would be a great fit and would love to have you" and a flawed moral compass. That said, I totally agree with the idea that we shouldn't allow these types of communications to significantly influence our rankings. My particular struggle was that it introduced a new rank option to my equation.

I do not agree with the poker analogy; this is not a zero sum game. Applicants and programs both "win" when applicants are matched at programs to which they are well suited and will thrive. Integrity will not magically arise from everyone continuing to consider this process a "game" in which social and ethical norms do not apply.
Click to expand...

Except that they're not real employers and the NRMP doesn't work through the same kind of channels like a post job interview process. If I got a letter back from an interviewer at a job saying that they wanted me, I'd tell them "Great! When should I expect to hear about an offer from HR?". The rules are different so don't conflate things.

The poker analogy is interesting because they can show you their hand and still be bluffing. It's much more along the lines of claiming "oh I have 3 of a kind" when the river gifted you a full house. There is nothing at all committing you to what you're saying.

I've posted this before, but I really like this article because it shows how frustrating this is from an administration level for folks that work with students and hear these kind of stories ad nauseum. This article also discusses the weird notion of 'yield protection' where folks want to know how far down their list they went. It's possible that they're firming up the bottom of their list if this is something they really care about. It makes zerooooo sense.

Assuring Integrity in the Residency Match Process : Academic Medicine

I do think that it's confusing that they offered you a position that you didn't apply to. Either they think that you'd be a great fit for it or they're trying really hard to match people to the program. If they really cared about you and what you wanted, they would have emailed saying that you were a great candidate and that they would consider you very strongly as an internal candidate for their 5 yr combined program should you match there. The fact that they're trying to give you a spot you didn't even ask for or apply to is troubling IMHO because it passes the line from 'looking out for you' to 'coercive'. And I can say this because you're now considering something that you're not even sure you wanted JUST because of an email they sent.

Maybe my opinion on this will change in time, but conversations with my own deans have basically told me that this is all hogwash. A classmate was talking about their urology match recently and said that programs basically asked them to commit pre-match. You have to play the game and go along with the bullcrap.
"Omg, I love you guys too. Yes yes yes i want to be your #1 and you'll be mine too!".
-Not a binding statement.

That person matched at their first choice, which is a giant in the field, and the program never once reached out to them in this fashion.
 
They told you (possibly inaccurately) their hand, but didn't show you. ...
Disclaimer: I am in the Memphis airport waiting for a flight to Vegas to play some poker, but know very little about the match
 
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