ROL Dilemma

[JOEYSOBANK]

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I had an interesting scenario happen to me recently. I'm curious to hear people's thoughts on the situation.

I interviewed for a residency program (in a very competitive specialty) that I had done an away rotation at recently. In my month elective there I made friends with almost the entire department and basically LOVED every single thing about the program -- the residents, the faculty, the way in which the schedule is broken down, how well the residents are trained, etc. (the list goes on).

When I went back for my interview it was like going home. I got mad love from everyone and at that point I told myself this is really where I want to be. Interestingly, two separate interviewers, who are important people in the department and field, told me that they would love to have me there, but they emphatically added that I should rank "more prestigious" programs higher than theirs when I make my ROL. This just doesn't make sense. Obviously, to match in the field I am applying for is a feat in and of itself, but to be at a place that I can truly be happy is an invaluable intangible.

Here's my question: Does it make ANY sense to rank "top tier, more prestigious" programs higher on your rank over lesser known programs that will train you to be an awesome clinician that you know you will be happy at? Their reasoning behind telling me to rank other prestigious programs higher was that I "would be closing doors" to myself later in my career -- particularly in academics. But I say that's nonsense. What do you have to say?

Perplexed for now,
Bank

 

[doc05]

which specialty? programs?

go with what you think is best for you.

 

[NinerNiner999]

I would say your choice could go either way. The fact that they want you and are telling to rank more "prestigious" programs tells me you will most likely be ranked highly by the program you interviewed at. If you like it there that much, I would rank it first and secure your spot.

I don't know more about you other than what you have just posted (specialty, career goals, research, etc) but I suggest that if you are interested in academic medicine or high-powered research you go for the big name program - it will only help. Then again, if you are comfortable with the other program, it may provide a more stress-free environment that will help you shine and distinguish yourself from your fellow residents, which will lead to excellent recommendations and credentials.

Having matched last year into a program that I ironically liked very much AND was prestigious, I can answer you from both sides. I don't think prestige matters when it comes to practice out of residency, but it can only help should you enter academics. Ultimately, go where you are happiest, where the cost of living is right, where the location makes you happy outside of the hospital, and where you will have people you can hang with out of work. I think those are the most important pieces of residency...

 

[marchiafava]

I am in the almost the same situation. This is what you need to ask yourself: Will I ONLY be happy at matriculating at this program I rotated at OR will I be just as happy matching at a more top tier program. This is the ONLY question you need to answer. If your answer is you will ONLY be happy matching at Program X you rotated at and loved, then ninerniner999 is correct in his/her statement of "If you like it there that much, I would rank it first and secure your spot." If you would be happy at any of the other programs, especially a top tier program, then DO NOT TAKE THE ADVICE OF NINERNINER, It is FLAWED!!! You should rank where your preference lies. If you rank Program X #10 or rank it #1, you have the SAME chance of matching there, as long as the program ranks you high enough to match there and you don't match at any of the previous nine programs on your list. So you see, if you think you have a SAFETY program that you would love to go to but would like to take a chance at matching at a top tier program, the match is set up for this!!!! You will only be hurting yourself by not ranking other programs ahead of Program X, that is if you wouldn't mind having a chance of matching at another program. I hope that is clear. In terms of training at a top tier program, Yes most of the time it is more beneficial. You be affored more opportunities for a great fellowship, MOST of time a better training, and also more prestige. Prestige of training at a top program is a real entity, people WILL look at you differently. If none of this matters to you, rank program X #1 and you will go there. If you want a chance at other programs, take your shot and rank Program X lower, you think they will rank you high SO you will have the same chance of matching at the program even if you rank them dead last!!!!!

Good Luck

 

[tangents]

also be sure to tell whichever program that they are at the top of your list...

 

[fourthyearmed]

Rank where you want to go #1 period. Don't worry about prestige.

 

[Schedule_II]

If you would be happy at any of the other programs, especially a top tier program, then DO NOT TAKE THE ADVICE OF NINERNINER, It is FLAWED!!! You should rank where your preference lies. If you rank Program X #10 or rank it #1, you have the SAME chance of matching there, as long as the program ranks you high enough to match there and you don't match at any of the previous nine programs on your list. So you see, if you think you have a SAFETY program that you would love to go to but would like to take a chance at matching at a top tier program, the match is set up for this!!!! You will only be hurting yourself by not ranking other programs ahead of Program X, that is if you wouldn't mind having a chance of matching at another program. I hope that is clear.

marchiafava is absolutely correct. Too many people misunderstand the algorithm that the match uses. Ranking program X lower doesn't hurt your chances of getting into program X.

There are only two ways that your ROL can hurt your chances of getting into program X:

1. You fail to rank program X at all.
2. You match with program Y, a program you ranked HIGHER than program X.

i.e. if you don't match with one of those programs you ranked higher than program X, then it's no different than had you actually ranked program X number 1 on your list.

 

[NinerNiner999]

If your answer is you will ONLY be happy matching at Program X you rotated at and loved, then ninerniner999 is correct in his/her statement of "If you like it there that much, I would rank it first and secure your spot."
Good Luck

And this was all that I suggested. If you want to go to the program you felt "at home" with, why rank anything else above it and risk not going to the place you are happiest? If you want to use the match to your advantage and take your chances with a prestigious program you have never rotated in, then rank your safety lower on your list as suggested. I wouldn't steer you wrong...