ROL anguish

[starmoon]

Situation is this: I have been told I'm ranked to match at Program A which is considered "top tier." Program B, which I liked the best, is not even "high 2nd tier" according to most people, although it's well regarded. I am pretty sure I would match at either program if I rank it #1, although I know program directors sometimes mislead applicants.

What do you think? For those of you further down the residency/fellowship line, do you have any insight? I do want to stay in academics. How much does the prestige of the program matter? Again, the one I like best is very good, it's just not what you'd call elite.

I am torturing myself about this... I need some perspective.

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[HarveyCushing]

Never believe a PD. Rank your list according to where you want to go. Don't rank it any other way or else you will probably end up regretting it. Your gut feeling is an important factor. In summary I would not take anything the program director says as gospel.

 

[starmoon]

Yes I realize that but that's not really what I'm asking. I would probably be happy with either choice, or a number of others lower on my list. The question is, how much should the prestige of the program affect my decision, if I want to stay in academics? Thanks.

 

[HarveyCushing]

Yes I realize that but that's not really what I'm asking. I would probably be happy with either choice, or a number of others lower on my list. The question is, how much should the prestige of the program affect my decision, if I want to stay in academics? Thanks.

Honestly you can go into academics from any program. The thing the top programs sometimes offer is more resources/support for resident research. That is not to say that other programs don't have research or support it.

Ultimately in the end all that will matter is publications and funding. You want to get a K award and eventually a R01. Some programs have better track records at helping their residents with this. But the name only goes so far. In the end it all boils down to how successful you are.

I wouldn't pick a program I was less enthused about just for the name. I would rather go to the program/city that I liked better since I will be there for 4 years of my life.

Do you plan on doing a fellowship? You could argue your academic career in someways won't start until your fellowship. Or will you just do general neurology?

 

[starmoon]

Thanks, that is reassuring. I'm sure I will do a fellowship, but for various reasons I am very unlikely to want to move again in 4 years. But the place I like has tons of fellowships and also tons of research funding/opportunities. I think I've made my decision and am feeling really good about it. Either one would really be fine but I think I will be a lot happier with the less prestigious one.

 

[daptomycin]

How common is it for programs to let someone know they are "ranked to match." I have yet to hear from any of the programs I interviewed at, save 1 or 2. I'd like to think I am at least somewhat competitive for the programs I am considering, but who knows...

 

[starmoon]

Don't worry, I haven't really heard anything official from anyone. I'm sure you are competitive if you got an interview. When I said I had been told I was ranked to match, that was unofficial, from an insider. (Big-name program in question happens to be my home program.) I am sure you are competitive if you got interviews at good places. Neurology is not a super competitive field!

 

[daptomycin]

Thanks for the words of encouragement.

Glad to see that you have made your decision. What a crazy time in our lives! Must be a relief to have your list figured out. I hope you will get your number 1!

 

[HarveyCushing]

Thanks, that is reassuring. I'm sure I will do a fellowship, but for various reasons I am very unlikely to want to move again in 4 years. But the place I like has tons of fellowships and also tons of research funding/opportunities. I think I've made my decision and am feeling really good about it. Either one would really be fine but I think I will be a lot happier with the less prestigious one.

I should add that I am also just a medical student and don't have as much experience as the attendings and residents/fellows on here. However my viewpoint is from talking with residents ahead of me. So please take it as a grain of salt.

There are many factors that can go into the process of a ROL. Location, how close to family, cost of living, reputation of program, gut feeling, overall training at program, depth of diseases seen, resident support, happiness of current residents, collegiality of faculty and residents...etc. The list can go on. I would say when it is all said and done, follow your guy if you can't decide between two programs. Seems like you would be happy at either so you really don't have anything to lose.

 

[DuraMatters]

I apologize if this has been answered before on the forum, but out of curiosity, does telling a program you are ranking them #1 have any tangible effect on match outcomes? At some level, I feel that it would increase the program's favoring of you because they would want people to rank who want to be there. However, I also understand that programs have already created rank lists and probably wont change them.

Any residents/people gone through the process have any input?

 

[Terpskins99]

Yes I realize that but that's not really what I'm asking. I would probably be happy with either choice, or a number of others lower on my list. The question is, how much should the prestige of the program affect my decision, if I want to stay in academics? Thanks.

I don't think prestige is that big of a deal. Go some place you feel you will be happy. Dealing with a malignant program is NOT WORTH IT. Most fellowships in neurology are not competitive. If you want to participate in academics, that is always going to be an option for you. You just have to be willing to dedicate the time (and likely lower salary) to do so. That said, I recommend everyone pursue programs that are considered tertiary care centers. You want to see as many interesting and varied cases as possible as a resident.

How common is it for programs to let someone know they are "ranked to match." I have yet to hear from any of the programs I interviewed at, save 1 or 2. I'd like to think I am at least somewhat competitive for the programs I am considering, but who knows...

I had a few programs respond like that. 'Course, I didn't end up matching there... so ???

I apologize if this has been answered before on the forum, but out of curiosity, does telling a program you are ranking them #1 have any tangible effect on match outcomes? At some level, I feel that it would increase the program's favoring of you because they would want people to rank who want to be there. However, I also understand that programs have already created rank lists and probably wont change them.

There is no way to know the answer to this question. Regardless, I would definitely try to maintain correspondence with them. Remind the program that you still think highly of them and still want to work there. I'd do so at least once before the rank lists are submitted (whenever that date is). Good luck guys!

 

[candyland]

I have a sorta related question:

my top 2 programs...I like both, one also has a more prestigious name (program B) than the other (program A)...but both are good...but B is also one where the residents are definitely worked much harder than A...

at this point I honestly like both and can see myself working at both and being happy...BUT, program B is in a city I would much rather live in (it is big, diverse, and also where my family lives), but it is only an advanced program...whereas program A is in a smaller city 2 hours away from family that is not as exciting to live in, but they are categorical...

I am leaning towards ranking A higher b/c of the categorical aspect, although I would much rather live in city of program B. I only have 4 prelim year programs that I am ranking, and I would probably be really happy with the first choice only...,my question is anyone have any insight to help me decide? should I rank A higher just because it is categorical, or should I risk it and rank B higher and see if I match prelim year also?

thanks for any input guys!

 

[typhoonegator]

I have a sorta related question:

my top 2 programs...I like both, one also has a more prestigious name (program B) than the other (program A)...but both are good...but B is also one where the residents are definitely worked much harder than A...

at this point I honestly like both and can see myself working at both and being happy...BUT, program B is in a city I would much rather live in (it is big, diverse, and also where my family lives), but it is only an advanced program...whereas program A is in a smaller city 2 hours away from family that is not as exciting to live in, but they are categorical...

I am leaning towards ranking A higher b/c of the categorical aspect, although I would much rather live in city of program B. I only have 4 prelim year programs that I am ranking, and I would probably be really happy with the first choice only...,my question is anyone have any insight to help me decide? should I rank A higher just because it is categorical, or should I risk it and rank B higher and see if I match prelim year also?

thanks for any input guys!

If you think you have a good to great chance of matching in at least one of your prelim choices, I would go with that. Choosing a program just because it is easy and safe (categorical) could really be a bummer later on for you. I had a similar decision back in the day, and I went with my gut and picked the prelim+advanced rather than the categorical. Bottom line, you're going to be a neurologist, so if you don't get your first choice of prelims, big deal. 3 years where you want to be beats 1 year where you don't (assuming you don't get your top prelim choice, which you might).

But if you really think you might not match prelim (honestly), then you might just want to rank the categorical program first to avoid any scrambling fuss.

 

[Meniscus]

As we should hope for the best and prepare for the worse....I have a question about the 'scrammble' now called SOAP.

How do you think it will change the course of partially matching into the advanced and not the prelim? Since this is the first year for SOAP, I'm curious about how programs are going to approach this process. (There might be a thread dedicated to this but a well deserved conversation I still believe for neuro-adv folks).

 

[rotel]

I have a question- what is the tangible benefit in matching at a prestigious, top-tier residency? Do you get better training than at a lower tier place? Do you get more lucrative job offers after finishing? Better chance for an academic career? More fellowships available?

Just wondering cause some people make a big deal about wanting to match at prestigious places, etc.

 

[typhoonegator]

Prestigious places are often prestigious for a reason. It isn't always the case, but there are some opportunities at top-tier programs that might not be available elsewhere. This is particularly true for academics, where the right mentor can open a lot of doors for NIH funding. Fellowship opportunities vary by program and matter as well, as programs tend to prefer internal candidates since they are a known quantity. Education quality varies greatly, however, and the "prestige" of a program does not reliably reflect the quality of didactic or on-the-job education.

If money is the object, then in private practice the prestige of a program matters far less, particularly if the partners in the practice don't know people who trained there.

 

[starmoon]

Aaagh!! Chairman of Neurology Dept at Very Prestigious Scary Program that is my #2 called me at home "not to put pressure on you," just to tell me that they want me. I was totally tongue tied. Just basically said, that's wonderful, I'm so glad to hear that. I sounded like a complete idiot. But I could not lie and say they are my top choice, and I hate that "I'm ranking you highly" bullsh*t. I'm sticking with my top choice of Less Prestigious Happy Program.

 

[Domenech]

Hehe, it's funny how similar a position you and I are in, yet entirely different. I am ranking my programs based on whether they offer H1B visa or J1 visa. I have an H1B program that is top class. But other H1Bs are mediocre. My J1 programs are pretty good. I don't know if I'd unconditionally rank all H1Bs above J1.