Residency Match tips for future applicants from current matched 4th year

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MedicineZ0Z

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I wanted to post this now before I forget about it but it'll help future applicants immensely with how the system works. I matched favorably (not my #1 though) but learned a lot about the process from being involved with a lot of 4th year friends this year + providing moral support to SOAPers this past week.

1. Rank every single program. No matter how bad the location is, or how little you like the program - rank it. One read through the SOAP reddit thread, seeing people with high stats and US MDs getting nothing, shows why you should absolutely rank everything. Just rank it last when it's bad but put it on there. If you are sure you don't want to rank somewhere, do not use the logic of "would rather go unmatched than go there" but use the logic of: "would rather not practice medicine ever than go there."

2. Apply to extra programs. An extra 1k spent on this process will save you in the long run. Be realistic with your scores in this process too, regardless of the specialty. If you don't have good scores, plan to apply to a very large # of programs.

3. Go to 15 interviews (at least) but aim for 17-20 if you can - unless you have very good scores and/or you're aiming for FM/IM. Even for those aiming for FM/IM, I would still go to 15. Don't be that guy who went to 11 places and didn't match, it happens... and while uncommon the consequences are extreme.

4. Auditions rotations are VERY specialty AND individual dependent. If it's FM/IM etc. don't even think about it. The likelihood of improving your chances with an audition rotation is extremely low. I think one PD on here put it at <5% (and often 0%) for those who improve their chances with an audition in a lesser competitive specialty. If it's a more competitive specialty - gauge it based on how competitive you are. If you're on par, don't bother. You should only audition at places where you have a lower chance of matching (of course surgical subspecialties etc. are an exception). Reason: residents are far more likely to dislike you than to like you more to the point where it moves you up on the rank list.


5. Do not take interest letters from programs seriously. They literally mean nothing. There are people who get love letters from programs that go unfilled. What does that mean? It means they got letters of interest from places that didn't even rank them!! Even being told "ranked to match" could very likely mean literally nothing.

6. Adding to the last point - ignore post-interview communication. Yes do follow up if needed with a thank you remark and yes do tell your top choice that they're your #1. But don't ever take post-interview communication seriously. It means nothing and it's stuff they tell everyone they interview.

Overall, this was literally a big game. A huge mind game really. Don't expect any honesty in this process from any side, and treat it like a game.
 
Thanks for this! I'm a 2nd year DO student but interested in IM. Not really gunning for anything drastically competitive, but location does matter to me. I've been told that getting your foot in door via 2-4 week auditions is a good idea, to just let the program become familiar with you prior to interview season. But it seems like the advice on auditions for IM are heavily mixed. I understand the inherent risk of doing poorly or having residents not like you, but isn't the potential upside just as, if not more critical? For what its worth, I'm talking about doing a rotation at a community hospital that's taken my schools students before, in a location that I'm really trying to get into.
 
I2. Apply to extra programs. An extra 1k spent on this process will save you in the long run. Be realistic with your scores in this process too, regardless of the specialty. If you don't have good scores, plan to apply to a very large # of programs.

3. Go to 15 interviews (at least) but aim for 17-20 if you can - unless you have very good scores and/or you're aiming for FM/IM. Even for those aiming for FM/IM, I would still go to 15. Don't be that guy who went to 11 places and didn't match, it happens... and while uncommon the consequences are extreme.

I have a few questions, if you'll indulge me:
1. How many programs did you apply to?
2. How many interviews did you attend?
3. Did you get one of your top 3 choices?
 
Thanks for this! I'm a 2nd year DO student but interested in IM. Not really gunning for anything drastically competitive, but location does matter to me. I've been told that getting your foot in door via 2-4 week auditions is a good idea, to just let the program become familiar with you prior to interview season. But it seems like the advice on auditions for IM are heavily mixed. I understand the inherent risk of doing poorly or having residents not like you, but isn't the potential upside just as, if not more critical? For what its worth, I'm talking about doing a rotation at a community hospital that's taken my schools students before, in a location that I'm really trying to get into.
Well here's the thing, what do you gain from rotating there? Are you competitive for that program based on your scores? If yes, what would you gain?
If you're worried about being missed on their radar during pre-interview screening (which does happen), I would reach out and show interest ahead of time and again when apps are submitted. That's all you need to be noticed.

Usually, when people have success with auditions it's when they were already competitive for that program to begin with and survived a month without annoying anyone. It's also easy to annoy people once rotating there. Late one time for no fault of your own? That counts. Missed something cause you aren't familiar with the EMR yet? Also counts. It's unnecessary risk and should be saved for true "reach programs."
 
I also just matched favorably and would contribute/add:

1. Apply widely and broadly, including to programs you would be less ecstatic to attend. You can always decline offers later.

2. Go to every offer you receive if you can, unless you've already attended a ton.

3. RANK EVERY PROGRAM. Based on what I've heard from friends/online, SOAPing is a literal nightmare.

4. Sounds obvious, but try to research every program and plan how you can talk about why you go there. I partially attribute my match on spending an extra day at the city (due to weird travel issues) exploring, which I was able to talk about during my interview. "Why do you want to come here?" is the second most common interview question (after the classic "tell me about yourself," of course")

5. If you are doing a non-surgical specialty, I wouldn't do an audition rotation unless there's one place that's a clear #1 for you (due to location, etc). Remember, you need to get everyone to like you to increase your rank, but only need one person to dislike you to hurt it.

6. Letters of interest (LOIs) have mixed opinions, but n=1, I got the interview at the place I ended up matching only after sending one there...
 
Hey everyone,

I went unmatched this year for IM and I believe it has to do with my scores and school. I am planning on applying to Family Medicine next match since I've always been interested in primary care medicine. I'm an US IMG who was supposed to graduate this year in June but not sure if I should remain a student and re-apply as a "graduating senior"?
My scores are 213/226/pass, all first time passes with no red flags. I'm having a hard time figuring out what to do this next year before the next match? Any suggestions? Should I get a job as a medical scribe and then reapply next year? Will I need new FM LORs? (I have two already)
 
Hey everyone,

I went unmatched this year for IM and I believe it has to do with my scores and school. I am planning on applying to Family Medicine next match since I've always been interested in primary care medicine. I'm an US IMG who was supposed to graduate this year in June but not sure if I should remain a student and re-apply as a "graduating senior"?
My scores are 213/226/pass, all first time passes with no red flags. I'm having a hard time figuring out what to do this next year before the next match? Any suggestions? Should I get a job as a medical scribe and then reapply next year? Will I need new FM LORs? (I have two already)
Better to maintain student status and keep getting some clinical/research experience. Do any additional rotations in FM that you can and get more FM letters. Use the ones you think are best, but definitely do get a new letter.
 
Go to 15 interviews (at least) but aim for 17-20 if you can - unless you have very good scores and/or you're aiming for FM/IM. Even for those aiming for FM/IM, I would still go to 15. Don't be that guy who went to 11 places and didn't match, it happens... and while uncommon the consequences are extreme.

I agree with most of the advice here, but this point is going to depend so heavily on your specialty and the strength of your application. I applied to 15 total programs and went on 10 interviews, and I felt comfortable with my match chances with that (and did indeed match). I honestly don't know anyone who did 15+ interviews, though that could just be my school.

tl;dr not everyone should panic if they don't have 15-20 interviews. Talk to your advisors about the competitiveness of your application for your specialty and plan your application strategy accordingly.

Hey everyone,

I went unmatched this year for IM and I believe it has to do with my scores and school. I am planning on applying to Family Medicine next match since I've always been interested in primary care medicine. I'm an US IMG who was supposed to graduate this year in June but not sure if I should remain a student and re-apply as a "graduating senior"?
My scores are 213/226/pass, all first time passes with no red flags. I'm having a hard time figuring out what to do this next year before the next match? Any suggestions? Should I get a job as a medical scribe and then reapply next year? Will I need new FM LORs? (I have two already)

Agreed that you're probably better off delaying graduation, so that your YOG won't be held against you next year.
 
I agree with most of the advice here, but this point is going to depend so heavily on your specialty and the strength of your application. I applied to 15 total programs and went on 10 interviews, and I felt comfortable with my match chances with that (and did indeed match). I honestly don't know anyone who did 15+ interviews, though that could just be my school.

tl;dr not everyone should panic if they don't have 15-20 interviews. Talk to your advisors about the competitiveness of your application for your specialty and plan your application strategy accordingly.



Agreed that you're probably better off delaying graduation, so that your YOG won't be held against you next year.
Can someone explain this to me? Why would my YOG be held against me. What are the cons of graduating?
 
Can someone explain this to me? Why would my YOG be held against me. What are the cons of graduating?
because you get labeled as a person who didnt match, what was the problem? what was the red flag? Why did other programs not consider you or not rank you highly enough? also ability to do away rotations as a student, advising services, help during soap, etc.
 
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because you get labeled as a person who didnt match, what was the problem? what was the red flag? Why did other programs not consider you or not rank you highly enough? also ability to do away rotations as a student, advising services, help during soap, etc.

so if you don't match and then try again the next year, if you don't graduate there is no way for programs to know you didn't match the year before assuming you didn't apply to the same specialty and or programs?
 
so if you don't match and then try again the next year, if you don't graduate there is no way for programs to know you didn't match the year before assuming you didn't apply to the same specialty and or programs?
i dont know the answer to that question, maybe they have to do work to figure out you are reapplicant, but previous grads have lower rates of matching, and the further you are from YOG the less likely you are to match.
 
Can someone explain this to me? Why would my YOG be held against me. What are the cons of graduating?

I know programs can filter by YOG - I’ve heard that many filter out YOG >5 years ago, but I don’t know if there are programs that have more restrictive filters. Even if not, programs seem to prefer MS4s to those that have graduated. It may be due to concerns of atrophy of clinical skills over the year, or just the reasons mentioned by other posters.
 
Hey everyone,

I went unmatched this year for IM and I believe it has to do with my scores and school. I am planning on applying to Family Medicine next match since I've always been interested in primary care medicine. I'm an US IMG who was supposed to graduate this year in June but not sure if I should remain a student and re-apply as a "graduating senior"?
My scores are 213/226/pass, all first time passes with no red flags. I'm having a hard time figuring out what to do this next year before the next match? Any suggestions? Should I get a job as a medical scribe and then reapply next year? Will I need new FM LORs? (I have two already)
When there is a possibility you might not match, ALWAYS have a plan B... I repeat.
 
Great thread...

The match is all about strategy. If you are a US student, you WILL match if you know how to play the game. It might not be your desired specialty or the program you want to get into.

I got classmates who matched into FM with board failure(s)
 
so if you don't match and then try again the next year, if you don't graduate there is no way for programs to know you didn't match the year before assuming you didn't apply to the same specialty and or programs?

I was told by someone who went through this process that programs will often assume you failed to match the previous year after applying to a different, more-competitive specialty.
 
I agree with most of the advice here, but this point is going to depend so heavily on your specialty and the strength of your application. I applied to 15 total programs and went on 10 interviews, and I felt comfortable with my match chances with that (and did indeed match). I honestly don't know anyone who did 15+ interviews, though that could just be my school.

tl;dr not everyone should panic if they don't have 15-20 interviews. Talk to your advisors about the competitiveness of your application for your specialty and plan your application strategy accordingly.



Agreed that you're probably better off delaying graduation, so that your YOG won't be held against you next year.
Yeah it's very person dependent. If you're very competitive for all 10 places you go to, then it's reasonable to only go to that many. But I would always play is on the safe side. I'd say applying to 15 programs is not enough though.
 
Yeah it's very person dependent. If you're very competitive for all 10 places you go to, then it's reasonable to only go to that many. But I would always play is on the safe side. I'd say applying to 15 programs is not enough though.

Again - for my specialty and application, I was advised to apply to 10-15, so I did err on the safe side. My point is that you can't rely on hard numbers like that because each person's application and circumstances will be different. That was the safe side for me; applying to ortho or something would be very different.
 
I would like to hit on the statement that you shouldn’t audition in non-competitive specialties. That is generally true UNLESS your dream program has a reputation of interviewing/ranking its auditioners higher. There are a small number of residencies that do. That is the only time you should.
 
I wanted to post this now before I forget about it but it'll help future applicants immensely with how the system works. I matched favorably (not my #1 though) but learned a lot about the process from being involved with a lot of 4th year friends this year + providing moral support to SOAPers this past week.

1. Rank every single program. No matter how bad the location is, or how little you like the program - rank it. One read through the SOAP reddit thread, seeing people with high stats and US MDs getting nothing, shows why you should absolutely rank everything. Just rank it last when it's bad but put it on there. If you are sure you don't want to rank somewhere, do not use the logic of "would rather go unmatched than go there" but use the logic of: "would rather not practice medicine ever than go there."

2. Apply to extra programs. An extra 1k spent on this process will save you in the long run. Be realistic with your scores in this process too, regardless of the specialty. If you don't have good scores, plan to apply to a very large # of programs.

3. Go to 15 interviews (at least) but aim for 17-20 if you can - unless you have very good scores and/or you're aiming for FM/IM. Even for those aiming for FM/IM, I would still go to 15. Don't be that guy who went to 11 places and didn't match, it happens... and while uncommon the consequences are extreme.

4. Auditions rotations are VERY specialty AND individual dependent. If it's FM/IM etc. don't even think about it. The likelihood of improving your chances with an audition rotation is extremely low. I think one PD on here put it at <5% (and often 0%) for those who improve their chances with an audition in a lesser competitive specialty. If it's a more competitive specialty - gauge it based on how competitive you are. If you're on par, don't bother. You should only audition at places where you have a lower chance of matching (of course surgical subspecialties etc. are an exception). Reason: residents are far more likely to dislike you than to like you more to the point where it moves you up on the rank list.


5. Do not take interest letters from programs seriously. They literally mean nothing. There are people who get love letters from programs that go unfilled. What does that mean? It means they got letters of interest from places that didn't even rank them!! Even being told "ranked to match" could very likely mean literally nothing.

6. Adding to the last point - ignore post-interview communication. Yes do follow up if needed with a thank you remark and yes do tell your top choice that they're your #1. But don't ever take post-interview communication seriously. It means nothing and it's stuff they tell everyone they interview.

Overall, this was literally a big game. A huge mind game really. Don't expect any honesty in this process from any side, and treat it like a game.
Away rotations. What if I want to match to west coast from an east coast school, but I am bad at impressing residents?
 
Away rotations. What if I want to match to west coast from an east coast school, but I am bad at impressing residents?
This is where the making contact via email or phone call showing interest. Then having a good reason if they ask you “why coast to coast?”
 
This is where the making contact via email or phone call showing interest. Then having a good reason if they ask you “why coast to coast?”

Other forms of contact, don't rotate if you can't impress.
Thank you for the input. How exactly do you go about doing the phone calls and emails? Is this after you set up your ERAS application and before interviews you would just call them and say "Hey I'm very interested in your program because blahblahblah" out of the blue? Or only after you interview? Or even before you put in apps?

Current MS3.
 
Thank you for the input. How exactly do you go about doing the phone calls and emails? Is this after you set up your ERAS application and before interviews you would just call them and say "Hey I'm very interested in your program because blahblahblah" out of the blue? Or only after you interview? Or even before you put in apps?

Current MS3.
I would do it before you submit apps and again after if you don't get a quick invite. The issue with post-submission is that large numbers of IMGs will also be contacting at the same time.
 
Add on note, schools should really tell their students to disregard post-interview communication. If you repeat it enough times, it will sink in. There's an unlimited # of disappointed ms4s right now because of fake love letters.
 
Here is one of my big takeaways from this year: use all of the personal/professional connections you can. Having someone pick up the phone and make a call for you goes a long way. There were a couple of programs I really wanted interviews to and I asked faculty who I had even just one or two interactions with at my institution if they would be willing to make a call for me. Both times that I did this I ultimately got the interview. Then, once I had decided on my #1, I told the program directly and also had faculty advocate for me again. I think this went a long way towards me matching at that program.

Of course, the caveats here are that I was roughly in the ballpark in terms of competitiveness (though at the low end) for these programs and the faculty in my specialty at my medical school are notoriously supportive of applicants. If you can identify specific programs that you are interested in I would consider asking around your advisors/department to see whether anyone has personal connections there and politely inquire if they would consider reaching out for you. I would rank making and using connections as one of the top 3-4 factors which seemed to make a difference in my interview season.
 
Here is one of my big takeaways from this year: use all of the personal/professional connections you can. Having someone pick up the phone and make a call for you goes a long way. There were a couple of programs I really wanted interviews to and I asked faculty who I had even just one or two interactions with at my institution if they would be willing to make a call for me. Both times that I did this I ultimately got the interview. Then, once I had decided on my #1, I told the program directly and also had faculty advocate for me again. I think this went a long way towards me matching at that program.

Of course, the caveats here are that I was roughly in the ballpark in terms of competitiveness (though at the low end) for these programs and the faculty in my specialty at my medical school are notoriously supportive of applicants. If you can identify specific programs that you are interested in I would consider asking around your advisors/department to see whether anyone has personal connections there and politely inquire if they would consider reaching out for you. I would rank making and using connections as one of the top 3-4 factors which seemed to make a difference in my interview season.

This is solid advice, more important now that programs are buried in applications. If there is a way to convey a genuine interest in a given program while abiding by the rules then go for it.
 
There's an unlimited # of disappointed ms4s right now because of fake love letters.

This. Reddit is full of this right now. That school which sent you a personalized email saying how strong of a candidate you are and how great of a resident you'll make? They sent it to dozens of other applicants too. Unless it says "ranked to match," assume any post-interview communication, no matter how generous, is just the program being polite.
 
This. Reddit is full of this right now. That school which sent you a personalized email saying how strong of a candidate you are and how great of a resident you'll make? They sent it to dozens of other applicants too. Unless it says "ranked to match," assume any post-interview communication, no matter how generous, is just the program being polite.
I personally know of more than 1 person who got a ranked to match email who didn't match to that program. And I know of a case of a program going unfilled, and a candidate not matching when that same program sent a ranked to match email!! Insane.
 
Ranked to match doesn't mean what most people think it means. And there isn't a clear definition. The best way to think about it is: Let's say a program has 10 positions and they matched those 10 positions within the first 50 people on the programs rank-order list. RTM could mean 2 things. #1 that the top 10 people on the programs list OR #2 the top 50 people on the program's list.

Applicants think it's #1
Programs think it's #2

This is a problem if a program matches in their top 40 applicants one year because applicant 41-50 got a RTM email and are super pissed that they didn't get into the program if they matched below where they put it on their rank list.

The best advice I got was to not contact programs after the match. I got a love letter from my #2, didn't respond, still matched there.
 
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I dont understand what the big deal is surrounding post interview-pre-match communication. It should be treated like spam. Its not like it should have an impact on your ROL. Even if it did, at worst you would match a spot lower on the list.There is no reason it would change your outcome.
 
I dont understand what the big deal is surrounding post interview-pre-match communication. It should be treated like spam. Its not like it should have an impact on your ROL. Even if it did, at worst you would match a spot lower on the list.There is no reason it would change your outcome.

It's because it's really stressful to actually put together a rank list because you're second guessing if you answered interview questions right, or if the program is really a good fit for you, and a million other things (rational or not). There is a sense of validation in post interview RTM emails that, even if you know 100% they don't mean anything, is impossible to ignore. I thought it would be easy to ignore them before I went through the process, turn out it's pretty tough.
 
It's because it's really stressful to actually put together a rank list because you're second guessing if you answered interview questions right, or if the program is really a good fit for you, and a million other things (rational or not). There is a sense of validation in post interview RTM emails that, even if you know 100% they don't mean anything, is impossible to ignore. I thought it would be easy to ignore them before I went through the process, turn out it's pretty tough.
makes sense, but shouldnt a ROL be based on where you want to go rather than where you think you will be ranked high enough to match?
 
I personally know of more than 1 person who got a ranked to match email who didn't match to that program. And I know of a case of a program going unfilled, and a candidate not matching when that same program sent a ranked to match email!! Insane.

So did the applicant call them and ask them what was up with that?
Are they under some sort of NDA? It seems like if they said rank to match and didn't follow through, that should be a pretty bad black mark in their reputation to future applicants...
 
So did the applicant call them and ask them what was up with that?
Are they under some sort of NDA? It seems like if they said rank to match and didn't follow through, that should be a pretty bad black mark in their reputation to future applicants...
Not that i know of. And there are always enough applicants to fill spots. There are also lots of intelligent imgs with good scores who dont match. Residencies have way too many options just like med schools do with premeds.


Remember the pontiac hospital case where the family bribed the hospital 400k for a spot for their son? For a hospital with a total census of 3 patients !!
 
I dont understand what the big deal is surrounding post interview-pre-match communication. It should be treated like spam.

Because, no matter how many times they're warned, people believe it, have their hearts broken, and flip out. Nearly a week after the match, the #1 topic on my specialty's interview reddit sheet right now is people venting about not matching at places where they got communication.
 
I get it. My ROL was based purely off of my preferences, but even so, love letters from programs at the top of my list definitely got my hopes up that I’d match there. It’s easier said than done to dismiss what they say.
 
makes sense, but shouldnt a ROL be based on where you want to go rather than where you think you will be ranked high enough to match?
Yeah for sure. That is the core idea behind the match. But in reality, the emotional part of making a list and really trying to think which program will be the best for you can be pretty tough when you are hashing out #6 vs #5. Or whatever rank the person struggles with.

So if you get a love letter from your #1, but then you don't match there, even if the love letter was just a "Thanks you were great, we would love to have you." It's hard not to get your hopes up, and then be crushed on matched day. This happened to a few people I know.

What also sucks is when your #1 doesn't send you a love letter, but the same program sends a love letter to your friend who is ranking them #18. Then you feel like crap.

For me, I matched at my #2. Super stoked. But the day after match was like, well what if I liked this other program better. And felt crazy because I was feeling bad about matching #2! Came to find out almost EVERYONE I know had a similar experience. Crazy process.
 
I am not sure how it works for non-competitive specialities, but for competitive specialities matching itself is a big deal. People make so much fuss about aways and this program and that program, but ultimately it's matching somewhere that counts. Many people I know going to competitive specialties talked so much about aways and how they killed it at their aways and their special strategy for aways and how aways ended up opening so many doors for them and they ended matching very low on their list. That said, they matched and that's great but all that strategy and freaking out and bragging about one program while putting down other programs didn't end up meaning anything.

Moral of the story: For competitive specialties, stop bragging or putting down a certain program, work hard, and be happy that you matched and will be a future physician in a competitive speciality that lot of people won't get into
 
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I am not sure how it works for non-competitive specialities

For the non-competitive folks, Monday means nothing. I didn't even check my email at 11:00 am or whatever. It's all about Friday. Many of us had a ton of interviews, so people put programs in tiers and say "if I match somewhere in my top 5, I'll be happy." Then they actually match #4 or #5 out of 15 and find themselves disappointed.

My (pessimistic/depressing) advice is to do just that: put your programs in tiers ("great," "good," "OK," "safety") rather than sinking all your hopes into a single program. Despite trying to do the former, I had a clear #1, and I spent part of match day replaying my interviews there in my head wondering what I did wrong.
 
For the non-competitive folks, Monday means nothing. I didn't even check my email at 11:00 am or whatever. It's all about Friday. Many of us had a ton of interviews, so people put programs in tiers and say "if I match somewhere in my top 5, I'll be happy." Then they actually match #4 or #5 out of 15 and find themselves disappointed.

My (pessimistic/depressing) advice is to do just that: put your programs in tiers ("great," "good," "OK," "safety") rather than sinking all your hopes into a single program. Despite trying to do the former, I had a clear #1, and I spent part of match day replaying my interviews there in my head wondering what I did wrong.
Yes that makes sense.
 
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For the non-competitive folks, Monday means nothing. I didn't even check my email at 11:00 am or whatever. It's all about Friday. Many of us had a ton of interviews, so people put programs in tiers and say "if I match somewhere in my top 5, I'll be happy." Then they actually match #4 or #5 out of 15 and find themselves disappointed.

My (pessimistic/depressing) advice is to do just that: put your programs in tiers ("great," "good," "OK," "safety") rather than sinking all your hopes into a single program. Despite trying to do the former, I had a clear #1, and I spent part of match day replaying my interviews there in my head wondering what I did wrong.

I have to disagree here. My roommate and I both matched into non-competitive specialties, and Monday was a huge deal. Even if the odds are in your favor, the relief of knowing you’ve matched is huge. We checked right at 8 am PST like everyone else.

Friday’s still important, but I don’t know anyone who didn’t stress over Monday.
 
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