Sent love letter, now not sure

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EMTA457

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Hey everyone. I know love letters have been discussed ad nauseum. Sorry to bring it up again. BUT I do have a bit of a situation... I sent a love letter to my top choice a few weeks ago, but recent personal situations changed which is making me re-think my rank list. I still absolutely would love to train at my top choice, but now I am not sure if it would be the best personal choice. I am not sure what to do in this situation. Can anyone in program leadership positions chime in on how much of an offense is it when PDs find out that you may or may not have ranked them first (assuming they ranked you in a rank to match spot?)? I feel very bad about this, but am not sure how else to remedy this situation.

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If you don't rank them #1 (and you were ranked to match), it will come back to haunt you professionally. Forever.

What kind of personal circumstances? The kind where program #2 is in the city where your mom/dad/twin is dying? In that case, I would email the old #1 PD now and explain. Otherwise, no.

If you follow enough of these threads, you will see stories from PDs who found out someone lied about their #1 spot because they matched elsewhere. Those students are now blackballed from any future spot at that institution. Not only that, but PDs talk. We're a relatively small field still. It could affect your future fellowship/attending chances at other locations. It's extremely unprofessional to tell someone they are your #1 and then change. Don't be a d*ck and torpedo your professional career.

tl;dr-- don't tell a PD they're your #1 unless you are 100% that they are, forever.
 
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I sent emails to top 3. Who cares, it all works out in the end. Once a class gets their residents they soon forget all of the hundreds of applicants unless there were some already existing professional ties.

Does your situation suck, kinda, but have a beer and forget about it.
 
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I sent emails to top 3. Who cares, it all works out in the end. Once a class gets their residents they soon forget all of the hundreds of applicants unless there were some already existing professional ties.

Does your situation suck, kinda, but have a beer and forget about it.

... Except I have spoken w residents who have ran into their interviewers/pds from other programs during conferences, who still remember them from their application.
 
You obviously don't tell 10 programs they are #1, but telling a few programs that you are ranking them highly is kosher. Also, once you are on the other side of it and get hundreds of thank you emails and love letters you begin to realize that these things have extremely little influence in your overall application. Maybe more in different specialities but most programs use a collective decision making process for ranking applicants that 1 I love you email to 1 person in that process its small potatoes.

Life happens and things change, and emailing 1 person and now having a change of heart is not a big deal. More importantly, rank lists are probably already done and emailing them a change of heart probably would only hurt you. The match is random and something like 50% don't match their top 1, its ok.
 
These forums really do have good information but the caveat is the creation of this extreme neuroticism over the smallest things. Is this really that big of a deal to create multiple threads and having conversations lasting pages? I feel like things like "love" letters and second looks affect your app just as much as your schools deans letter, which is not at all.


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What if something recently changed about the program since sending the letter? For example, what if an applicant were to send a "you're my #1" letter and the following week the PD announces that he/she is stepping down?
 
Hey everyone. I know love letters have been discussed ad nauseum. Sorry to bring it up again. BUT I do have a bit of a situation... I sent a love letter to my top choice a few weeks ago, but recent personal situations changed which is making me re-think my rank list. I still absolutely would love to train at my top choice, but now I am not sure if it would be the best personal choice. I am not sure what to do in this situation. Can anyone in program leadership positions chime in on how much of an offense is it when PDs find out that you may or may not have ranked them first (assuming they ranked you in a rank to match spot?)? I feel very bad about this, but am not sure how else to remedy this situation.

Just rank who you want first, regardless of letters. Yeah, it's crappy to send that letter and then not rank them first, but you don't owe anybody anything, and you need to look out for yourself in the match. In the off chance that the PD finds out or even cares that you matched somewhere else, it won't matter. Fellowships and jobs coming out of residency are a dime a dozen, easy to get. You'll be fine. Just try and match where you want or need to match.
 
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If you don't rank them #1 (and you were ranked to match), it will come back to haunt you professionally. Forever.

What kind of personal circumstances? The kind where program #2 is in the city where your mom/dad/twin is dying? In that case, I would email the old #1 PD now and explain. Otherwise, no.

If you follow enough of these threads, you will see stories from PDs who found out someone lied about their #1 spot because they matched elsewhere. Those students are now blackballed from any future spot at that institution. Not only that, but PDs talk. We're a relatively small field still. It could affect your future fellowship/attending chances at other locations. It's extremely unprofessional to tell someone they are your #1 and then change. Don't be a d*ck and torpedo your professional career.

tl;dr-- don't tell a PD they're your #1 unless you are 100% that they are, forever.

Pffft...this post was way too dramatic. If a program or PD were this petty, I wouldn't want to work with them anyway. It's not like he's signing a job contract and then tearing it up.
 
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If you don't rank them #1 (and you were ranked to match), it will come back to haunt you professionally. Forever.

What kind of personal circumstances? The kind where program #2 is in the city where your mom/dad/twin is dying? In that case, I would email the old #1 PD now and explain. Otherwise, no.

If you follow enough of these threads, you will see stories from PDs who found out someone lied about their #1 spot because they matched elsewhere. Those students are now blackballed from any future spot at that institution. Not only that, but PDs talk. We're a relatively small field still. It could affect your future fellowship/attending chances at other locations. It's extremely unprofessional to tell someone they are your #1 and then change. Don't be a d*ck and torpedo your professional career.

tl;dr-- don't tell a PD they're your #1 unless you are 100% that they are, forever.

Things happen in life. Get over it.
 
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OP, write it off in your mind, you have to do what's best for you.

There is absolutely nothing binding until you open that envelope on match day.
 
In the past week it seems that future applicants have been instructed to tell residents to suck their dicks at preinterview dinners and to send emails to multiple programs saying that they are their number one program.

Nice.
 
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What if I sent a nonspecific letter to a program I am ranking highly (not #1) and from their response it seems like they think I am ranking them #1? I feel like my email was completely misinterpreted, as I wrote that I would be thrilled to match at their program. The response was that the PD is happy I want to come to that program. Now I feel terrible as I still have no intention of ranking that program first. Seems like they misinterpreted? Or am I reading too much into the response?
 
What if I sent a nonspecific letter to a program I am ranking highly (not #1) and from their response it seems like they think I am ranking them #1? I feel like my email was completely misinterpreted, as I wrote that I would be thrilled to match at their program. The response was that the PD is happy I want to come to that program. Now I feel terrible as I still have no intention of ranking that program first. Seems like they misinterpreted? Or am I reading too much into the response?

Go drink a few beers and get over it
 
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no one care about your letter.
no one will care whether you match at the program or not.

Don't send a letter that you changed your mind.
Just move on and rank in the order of your preference.
 
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My perspective for what its worth...

People telling you they rank you number one only to go elsewhere absolutely makes PD's not trust other candidates who say the same thing. And programs telling candidates that's they rank them to match and candidates not matching there does the exact same thing.

In the end the general answer is you should never lie about the stuff, but people understand things change sometimes. If something changed, it changed. You are under no obligation just because you told program you were writing them number one to still write them that. It does hurt your credibility, but I certainly wouldn't write a letter telling a program that you no longer a ranking them highly before the match.

I personally think a good way to handle your specific situation is to wait until after the match. If you match elsewhere at the program you ranked higher than the one you said was #1, you could shoot a quick email off to the PD and explain. Complementing their residency program, telling them you had every intention of ranking them first but you had a social change which changed your rank list at the last second. And wishing them the best of luck with their current residency class. That actually happened to us last year with a student we really thought highly of, and we didn't begrudge him at all because he wrote to us and thanked us afterwards and explained what changed. If he ever needed a job and we had an opening, we would never hold it against him.

More generally on this topic, in the end does any of it matter if you lie if you are the sudent or program? It matters if you honor your credibility. Is there any other repercussions to you? Absolutely not. But I do agree that PDs remember people who lie to them. That's not being petty. It's unprofessional to lie to someone. Especially when a program spent a month providing a rotation, housing, food, writing a sloe, and the school evaluation for you. A lot of time goes into training medical students, I don't think it's unreasonable to ask for people to just be professional and not lie to one another when a program spent a lot of time helping your application. You don't owe anything to any program in terms of where you rank them. But I do think you owe people common courtesy to not lie. That goes both ways.

I do agree that if you ran into somebody at a conference it would be petty for them to bring it up. Hell that person that lied to you in the end did you a favor, because in the end you don't want to populate your residency with a bunch of unprofessional folks that lie anyways. But on the otherhand, I think it would be very difficult to hire a residency graduate to be faculty at your program from another residency, if you knew that person lied directly to your face three years before. And yet there are tons of students who have chosen to go elsewhere who I would support hiring in a second when they graduate from another program. It's not about not being wanted; that WOULD be petty. It's about not being an adult professional and lying, and those are two very very different things. I'm sure this is exactly the same from the student end. If a program lied to you as a student, and you didn't match there, I hardly think if they were hiring three years later you would sign a contract there. There's no point in associating yourself with people who are not professionals.

Just my 2 cents...
 
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Don't hate the player, hate the game.

This system creates situations like this. All people want after four years of getting **** on and paying six figures for the privilege is having the chance to train to do what they want to do.
 
Don't hate the player, hate the game.

This system creates situations like this. All people want after four years of getting **** on and paying six figures for the privilege is having the chance to train to do what they want to do.

Nope. I have every right to not respect a lier. And they have every right not to respect someone that lies to them.

I agree that all people want to have the right to do what they want to do. Unfortunately that's not the reality. I would like to be a professional golfer. I would like to make $10 million a year. Just because I would like that and if I took out $500,000 in loans to get top-notch coaching, I still couldn't putt to save my life and my handicap would probably still be >10. Wanting to do something or spending money on something doesn't guarantee you the chance to do something. You either earn it or you don't. Unfortunately there are just limited training spots. If you are not as qualified as other people, the reality of the situation is sometimes you won't get what you want. That stinks to hear, but it's the reality of life. And while that hard reality is what it is, there is no reason to compromise basic professional behavior just to try to to get some perceived advantage that's really not even real. No one should lie to anybody in order to try to game the system. If you don't value your credibility, that's fine, but just don't encourage other people to not value their's.
 
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You're assuming you're in Program A's top whatever #. Maybe you're #11 on their list and they get their top 10 and then they never know. Unless you were their #1 student and you're going to try to get a job there immediately after graduation, it's never going to haunt you. Maybe you rank program B first and fail to match there and still end up at Program A. Or maybe despite all this you end up at your 8th program and none of it matters.
**** happens. Significant others get a say, family gets a say, last minute jitters make people change their rank lists the day it is due. So many factors play into it and there's 100 people applying for the same spots. That's why we repeatedly tell students not to try to game the system and just rank it like a wish list.

I wouldn't email them now, I wouldn't email them after. Let it go. If they can't let it go and for some reason hold a grudge, they're a special brand of crazy.
 
You're assuming you're in Program A's top whatever #. Maybe you're #11 on their list and they get their top 10 and then they never know. Unless you were their #1 student and you're going to try to get a job there immediately after graduation, it's never going to haunt you. Maybe you rank program B first and fail to match there and still end up at Program A. Or maybe despite all this you end up at your 8th program and none of it matters.
**** happens. Significant others get a say, family gets a say, last minute jitters make people change their rank lists the day it is due. So many factors play into it and there's 100 people applying for the same spots. That's why we repeatedly tell students not to try to game the system and just rank it like a wish list.

I wouldn't email them now, I wouldn't email them after. Let it go. If they can't let it go and for some reason hold a grudge, they're a special brand of crazy.

I agree it would be crazy to hold a grudge. What I'm saying is not about holding a grudge. I'm saying you would never professionally want to work with that person again, because you know that person lacks integrity. The person that lies to you is giving you insight into who they are, what their sense of honor is. I guarantee you after the match if a program wanted you and you lied to them, they'll be annoyed, but then they'll just forget about it and move on. And thats it, no one has a grudge or will care at all about it. Unless for some reason you wanted to professionally work with those people at a later time, thats when theyll care. Because it's not the programs can't handle getting the candidates they want. That stuff blows over quickly. It's not about that. Its about a credibility issue years down the road if you ever were looking for a job at a place. I just can't imagine a place signing someone to a contract unless they were desperate if they knew flat out that person lacked credibility.

Now that being said, the chances of you trying to get a job at that site a few years from now are slim, so in the end it probably doesn't matter. And in the original posters case, he wasn't lying. He genuinely did believe he was going to rank that program first, so I don't think there's any issue with him changing his mind.

I think the bigger issue is the general sense of people just not being honest with the system. Both programs and candidates. We uphold ourselves as one of the most honorable professions, yet are willing to lie to eachother in order to try and get some slight perceived advantage? Its below us all frankly.
 
I guess an analogy to drive what I mean by not holding a grudge yet affecting you later...

You have two former college friends in business school, both studying to be financial planners while you are in residency. You are out at a restaurant and the check comes, both were strapped for cash and you pick up the check with both saying they'll pay you back. They both owe you something like $50. One guy gives you the money the next week. The other makes an excuse about still not having it, and then both sides just forget about it. These guys are your friends and its only $50. You aren't going to get angry, hold a grudge over it, or lose a second of sleep over small amount of money. But 5 years later, you are looking a sizable chunk of money, and both financial planners have an equal success record with their investments. Who would you advise you? There was never a grudge there, anger, or resentment over a menial $50, but when you have to make a significant investment, then the integrity does matter in who you choose. Its not about being petty, a sore loser, holding a grudge, etc. It's about valuing professional behavior when you are making sizable investments in hiring professionals.
 
If you don't rank them #1 (and you were ranked to match), it will come back to haunt you professionally. Forever.

What kind of personal circumstances? The kind where program #2 is in the city where your mom/dad/twin is dying? In that case, I would email the old #1 PD now and explain. Otherwise, no.

If you follow enough of these threads, you will see stories from PDs who found out someone lied about their #1 spot because they matched elsewhere. Those students are now blackballed from any future spot at that institution. Not only that, but PDs talk. We're a relatively small field still. It could affect your future fellowship/attending chances at other locations. It's extremely unprofessional to tell someone they are your #1 and then change. Don't be a d*ck and torpedo your professional career.

tl;dr-- don't tell a PD they're your #1 unless you are 100% that they are, forever.

A little neurotic much? PD care about match list but not that much no one is that special there are 20 other applicants on a competitive program's match list that are just as good. Only malignant program directors would care. Also EM fellowships are not that competitive at all. Also it's fine to bad talk med students but residents will become attendings in a short amount of time. Being that much of a dick would likely just harm you in the end.
 
#1 thing is to never lie. This carries forward into residency and beyond. Don't compromise yourself. Let me tell you, if I ask a medical student or a junior resident about the cerebellar exam in a dizzy patient and they lie to me and say they did it and they didn't, their credibility is shot and it will take a long time before I can trust them again. If it is a sub-I, I will make sure they don't match here. We have had residents at my facility terminated because of higher grade forms of this that led to poor patient outcomes.

That being said, the OP isn't lying. They acted on information they had at the time and now something changed. Honestly, it's not a big deal. For someone to not want to work with you professionally again in the future because of this is indeed holding a grudge, and you do not want to work for that kind of a boss.

I actually like the idea of sending a quick 2 sentence email post-match. It will absolve you of any perceived moral indiscretion and will totally make you feel better, even if you receive no response.

It's unfortunate that The Match has a perceived culture of "gaming the system." I think post interview communication contributes to this feeling. The NRMP should weigh in on this at some point.

I'm frequently amused how well some program admins believe they have it all figured out. We've matched former sub-Is that everyone "loved" only for them to turn out to be a complete dud clinically or have odd behavioral issues. I'm sure the one's that we've "not liked" have gone on to other fantastic programs and will work hard to become competent physicians.

Being a med student / applicant / resident is hard. Gotta cut people some slack sometimes.
 
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Make a choice for you. Now. Don't ever do it because you think its what your career needs, or because you are afraid some well-intentioned email of praise will be misconstrued as dishonesty. You will match somewhere, become an excellent emergency physician, and you have a simple choice to make now - worry about how personal decisions will effect you for the rest of your life, or live the life that caused you to make the decision.

Your mindset is what is wrong with the physician role in healthcare. There is this altruistic belief that you must be a slave to your master. This is not in the hippocratic oath! Be a slave to your patients, but be true to yourself. Physician! Heal Thyself. It's time to cut the cord and start living your life.
 
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I think people are being a bit overly dramatic with calling him a liar. He/she admits circumstances changed and it made him potentially reorder his list. Seems fine to me. Rank in the order you want OP, its your life, don't let random internet people make you feel bad about your own decision on where you want to go. Anyone, program or applicant, who even believes these "love" letters in the first place has some waking up to do.
 
I don't think anyone called the OP a lier. I specifically said more general, don't lie and tell a bunch of programs your my #1, just like programs shouldn't tell 50 candidates you're in our top 10. But in his case, I said the OP specifically didn't lie. Things just changed.
 
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Why not just send a genuine email after match? If you end up matching there then no harm no foul (just sounds like it may be more inconvenient for you personally). If you get your first pick, send a thankful email to the program director you sent the love letter to saying something to the effect of , 'this is where I matched, I don't know how I was ranked on your list but I just wanted to let you know I had to change my list for unexpected personal reasons. It's a small community and I hope to run into you in the future and would look forward to any opportunity to work together in the future.

I can't imagine this would harm you in any way and I believe it could mend any burnt bridges.
 
Why not just send a genuine email after match? If you end up matching there then no harm no foul (just sounds like it may be more inconvenient for you personally). If you get your first pick, send a thankful email to the program director you sent the love letter to saying something to the effect of , 'this is where I matched, I don't know how I was ranked on your list but I just wanted to let you know I had to change my list for unexpected personal reasons. It's a small community and I hope to run into you in the future and would look forward to any opportunity to work together in the future.

I can't imagine this would harm you in any way and I believe it could mend any burnt bridges.

I personally like this approach. I mean, yes its a small community, but lets be honest, its still EXTREMELY unlikely you'll wind up having to work with someone at the place you changed your mind about. But I still think its common courtesty and a professional thing to do.

Some programs also do contact students after the match and ask for feedback. We usually email anyone above the point where we went down to on the list, but didn't match. We genuinely congratulate them on matching where they did, and we ask for any feedback about the interview day, their perception of our program, what we can improve to make us more attractive to applicants, etc. I'd say we probably hear back from 20% or so, but those that take the time to reply are phenomenal and give us tons of insight.

I don't begrudge any student for choosing another program, I genuinely want people to first match somewhere, and second match where they want to. And both students and programs can help each other considerably by just being honest with each other.
 
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Just want to say thank you gamerEMdoc and Ninerniner999. Your contribution to this discussion helped me relax 10 fold about this whole process as silly as that may be.
 
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OP, I have been in a similar position. I had sent a LOI early in February around the time programs were finalizing their rank lists. However, in the time since that letter personal circumstances, gut feeling, and sleepless nights led me to reconsider. I wound up sending a brief email to the PD before the ROL deadline detailing my thoughts and reasons, along with an apology for my previous commitment. It worked out wonderfully.
I think as medical students we build up these situations in our minds and make them into a huge deal. In reality, PD's are ranking 100s of us. They understand the process, and just how hard and momentous a decision like this is. In the end, they want us to match at the program we are most happy at (even if it is not their own) as this will allow us to continue growing in our education.
Good luck bud, it's going to work out great!
 
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Hey everyone. I know love letters have been discussed ad nauseum. Sorry to bring it up again. BUT I do have a bit of a situation... I sent a love letter to my top choice a few weeks ago, but recent personal situations changed which is making me re-think my rank list. I still absolutely would love to train at my top choice, but now I am not sure if it would be the best personal choice. I am not sure what to do in this situation. Can anyone in program leadership positions chime in on how much of an offense is it when PDs find out that you may or may not have ranked them first (assuming they ranked you in a rank to match spot?)? I feel very bad about this, but am not sure how else to remedy this situation.
Don't worry about this. Write them all "love letters." You want everyone to rank you as high, as possible.
 
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