ROL question

[rxfudd]

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So let's say that an applicant gets tons of interviews everywhere that he or she applies and only interviews at the biggest names of these programs (Cincinnati, Ohio State, Hennepin, etc) and turns down all of the more community type or less well known programs. Is that person taking any sort of risk by submitting a ROL of 10-12 of the more competitive programs? Would it be in his interest to interview at one or two less competitive places and rank them low as a safety? Not that I'm exactly in a position to do this, more that I'm curious how the match would treat this scenario.

 

[EctopicFetus]

The match treats it like any other scenario. Meaning if the # 1 EM program in the country (i.e. the Inn 'n Out) ranks you # 1 and you rank them # 1 then you will end up there. Conversely from your list you rant Cincy, OSU, and Hennepin 1,2,3 and they dont rank you then you wont match. I guess you are asking if you ranked the top 10-12 progs in the country what would be your chance. The answer has to be it depends on how competetive you are and how much they like/dislike you. I doubt this helps but I think thats how it is.

 

[CS_22]

So let's say that an applicant gets tons of interviews everywhere that he or she applies and only interviews at the biggest names of these programs (Cincinnati, Ohio State, Hennepin, etc) and turns down all of the more community type or less well known programs. Is that person taking any sort of risk by submitting a ROL of 10-12 of the more competitive programs? Would it be in his interest to interview at one or two less competitive places and rank them low as a safety? Not that I'm exactly in a position to do this, more that I'm curious how the match would treat this scenario.

I really like this question, and would be interested if some of the residents/new attendings could shed some light on this question. I mean, what if you are a semi-competitive applicant who somehow gets ten or so really good residency interviews. Is it a good idea to keep a couple "less competitive" places on your ROL in order to be "sure" about matching. I wouldn't wanna be not ranked at the ten or so competitive places and then have to scramble.

CS

 

[Seaglass]

If you get 10 or more "competitive" interviews then you aren't a semi-competitive resident, you're very competitive. In reality, if you are good enough to get an interview at all of the highly desirable programs then odds are you will rank high enough to get into one. That said, a safety is pretty common in most ROLs. But remember, just because a program isn't the most desirable doesn't mean they will automatically rank you, mr. supercompetitive applicant, highly. Programs want people interested in going there, and they're not too dumb to realize that your matching there would probably make you a miserable resident.

 

[bartleby]

Sorry, but I feel the need to throw my $0.02 in here. Too many people are losing the forest through the trees in terms of program selection. Yes, going to the "best" program you can get into is ideal. But the contribution of your residency program to your success or failure as a physician is so much more than rubbing elbows with The Renowned Dr. X for three or four years. While this idea is charming, it is misguided on many levels.

As individuals, you need to look deep within yourselves and try to figure out what you need in a residency. Were you the one who showed up five minutes early to every lecture and need a regimented learning style? Did you win the "Distance Learning" award in the first two years of med school? Are you an independent learner or comfortable in a more regimented environment? Nothing makes for an unhappy resident like winding up the only square peg in a program.

And, most importantly, you need to remember that you're not headed to prison on some sort of medical plea bargain. You need to find a place that you're going to be happy, because if you're miserable, you aren't going to learn squat. And, as one of my advisors told me in med school, consult your spouse or significant other in the choice, because, "...if you're wife isn't going to be happy in X, you certainly aren't going to be either..."

It's my belief that only a fool turns down an interview in a place that seems like it could be a good fit for them because Judith Tintinalli isn't on the faculty. There is so much more to a residency program than this.

And last, but not least, remember that there is an element of the Harvard Syndrome in all of this. Just pick up a finance magazine and read the articles about saving for college... everybody thinks their kids are going to Harvard. Well, guess what... not everybody does. *Fail to diversify your rank list at your own peril.*

So let's say that an applicant gets tons of interviews everywhere that he or she applies and only interviews at the biggest names of these programs (Cincinnati, Ohio State, Hennepin, etc) and turns down all of the more community type or less well known programs. Is that person taking any sort of risk by submitting a ROL of 10-12 of the more competitive programs? Would it be in his interest to interview at one or two less competitive places and rank them low as a safety? Not that I'm exactly in a position to do this, more that I'm curious how the match would treat this scenario.

 

[EctopicFetus]

Sorry, but I feel the need to throw my $0.02 in here. Too many people are losing the forest through the trees in terms of program selection. Yes, going to the "best" program you can get into is ideal. But the contribution of your residency program to your success or failure as a physician is so much more than rubbing elbows with The Renowned Dr. X for three or four years. While this idea is charming, it is misguided on many levels.

As individuals, you need to look deep within yourselves and try to figure out what you need in a residency. Were you the one who showed up five minutes early to every lecture and need a regimented learning style? Did you win the "Distance Learning" award in the first two years of med school? Are you an independent learner or comfortable in a more regimented environment? Nothing makes for an unhappy resident like winding up the only square peg in a program.

And, most importantly, you need to remember that you're not headed to prison on some sort of medical plea bargain. You need to find a place that you're going to be happy, because if you're miserable, you aren't going to learn squat. And, as one of my advisors told me in med school, consult your spouse or significant other in the choice, because, "...if you're wife isn't going to be happy in X, you certainly aren't going to be either..."

It's my belief that only a fool turns down an interview in a place that seems like it could be a good fit for them because Judith Tintinalli isn't on the faculty. There is so much more to a residency program than this.

And last, but not least, remember that there is an element of the Harvard Syndrome in all of this. Just pick up a finance magazine and read the articles about saving for college... everybody thinks their kids are going to Harvard. Well, guess what... not everybody does. *Fail to diversify your rank list at your own peril.*

My kid is GOING TO HARVARD!!! and BTW Excellent post.. 👍

 

[WilcoWorld]

If my kid wanted to go to Harvard, I'd request a paternity test. If my kid wanted to go to Yale, I wouldn't need one.

Just kidding.

The simple answer to the OP's question is that competitive programs draw competitive applicants, so, yes, it will take more to stand out on those rank lists. The more complicated answer is that neither residents, attendings, nor even PD's can tell you what your "magic number" of programs needed to secure a match will be. Even if a knowledgable person analyzes your scenario in detail, he/she can not tell you with certainty what the future will hold.

However, the most commonly cited "magic number" is 10, and while some go deeper in their lists than 10 & most don't get past #5 I think 10 is a pretty good bet regardless of which programs comprise your list (please note the complete lack of certainty in that statement). Consider this; even though Program Ultra-Competitive has a list of very competitive applicants, those same applicants are likely to have a similarly impressive list of interviews. So, while Mrs. Step 1 =265, etc. may only rank at spot #12 on PUC's list, those ranked 1-11 may have listed PUC at #3 behind Program Super-Duper Competitive(#2), and In 'n Out(#1). While the applicants feel like the programs are holding all the cards, the truth is that the interview trail is a two way street, for the number of applicants who rank EM matches-up rather closely with the number of available spots.

The only things I can say with confidence about the whole matching process are the painfully obvious:
The more programs you rank, the more likely you are to match.
If you don't rank a program, you wont match there.
Beauty is in the eye of the beholder, so vying for "competitive" programs for the sake of competitiveness misses the point - as hard as that is for an MS4 to accept, it's true.

 

[rxfudd]

On the one hand, I agree with what you're saying. Realistically, though, outside of one's hometown, I don't think many people are able to evaluate their "fit" with a program based on a review of their website and scutwork.com. Once you've interviewed everywhere, it's easy to say "go where you feel most comfortable". But when you're choosing where to interview in the first place, this is pretty tough to do. I think everyone gravitates towards the programs they have heard of before (i.e. the "bigger names"). I know that I'm much more likely to consider interviews at "big names" simply because I've heard of them rather than these small community types I don't have any impression of (positive or negative). The reality for most of these places is that up front, I have nothing on which to form an opinion other than the name and reputation.

Sorry, but I feel the need to throw my $0.02 in here. Too many people are losing the forest through the trees in terms of program selection. Yes, going to the "best" program you can get into is ideal. But the contribution of your residency program to your success or failure as a physician is so much more than rubbing elbows with The Renowned Dr. X for three or four years. While this idea is charming, it is misguided on many levels.

As individuals, you need to look deep within yourselves and try to figure out what you need in a residency. Were you the one who showed up five minutes early to every lecture and need a regimented learning style? Did you win the "Distance Learning" award in the first two years of med school? Are you an independent learner or comfortable in a more regimented environment? Nothing makes for an unhappy resident like winding up the only square peg in a program.

And, most importantly, you need to remember that you're not headed to prison on some sort of medical plea bargain. You need to find a place that you're going to be happy, because if you're miserable, you aren't going to learn squat. And, as one of my advisors told me in med school, consult your spouse or significant other in the choice, because, "...if you're wife isn't going to be happy in X, you certainly aren't going to be either..."

It's my belief that only a fool turns down an interview in a place that seems like it could be a good fit for them because Judith Tintinalli isn't on the faculty. There is so much more to a residency program than this.

And last, but not least, remember that there is an element of the Harvard Syndrome in all of this. Just pick up a finance magazine and read the articles about saving for college... everybody thinks their kids are going to Harvard. Well, guess what... not everybody does. *Fail to diversify your rank list at your own peril.*

 

[tennik]

Getting to the root question, I think that interviewing and ranking a couple safe programs is a good idea. Even if you are super competitive it is good to cover your butt. Seems like it's the fairly competitive applicants that often get burned and don't match due to their optomistic rank lists.