Signal home program after doing not so great on Sub-I?

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Mamapa2

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Hi, USMD applying into a moderately competitive specialty this year (80s% match rate for USMDs) and while I have average/above average grades/step for the specialty, in no ways am guaranteed to match. Still, I unfortunately did not do the best on my home sub-I and one of the chief residents and a faculty member left some negative professionalism comments on my evals (nothing major, just about asking questions out of place and hence limited interpersonal skills). Most of my other evaluations were positive and honors but my PD did come meet with me during the rotation to voice their concern.

So my sub-I has ended now and I met with PD recently to talk about my chances for my home program given my performance. PD indicated that they only take students who signal and if I were to signal I would be interviewed, but if I did not signal, I wouldn't be considered at all. I further asked about my chances of being ranked and the PD said that I will definitely be interviewed if I signal but cannot give further information.

As most of the faculty and the chief residents at my home program play a key role in ranking applicants, I am wondering if I should signal to get the guaranteed interview but risk being ranked low/DNR or alternatively, not signal at all and use the signal on somewhere else where I have a clean slate, since I am limited to only 10 - 15 signals. Thanks!

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Don’t waste the signal unless you get some insider intel that you’d be strongly considered. Given what you’ve said, sounds like odds of matching there aren’t good so spend your signal elsewhere.

Getting an interview doesn’t really matter, it’s the matching that counts.
 
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Agree with above. Think through it a bit more: Let's take a stellar student who just WOWed everyone. They apply, but don't signal. Does the program really have a hard and fast rule that they NEED a signal from a home student to interview them and thus do not interview that student? I guess it's not out of the realm of possibilities, but seems odd to me.
 
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Agree with above. Think through it a bit more: Let's take a stellar student who just WOWed everyone. They apply, but don't signal. Does the program really have a hard and fast rule that they NEED a signal from a home student to interview them and thus do not interview that student? I guess it's not out of the realm of possibilities, but seems odd to me.
Forgot to mention that my PD requires everyone to signal (even home applicants who WOW everyone) for an interview but interviews are not guaranteed to all who signal (but may be guaranteed to home applicants who signal regardless of profile).

Still, it sounds like I shouldn't apply to my home program then and look elsewhere?
 
Hi, USMD applying into a moderately competitive specialty this year (80s% match rate for USMDs) and while I have average/above average grades/step for the specialty, in no ways am guaranteed to match. Still, I unfortunately did not do the best on my home sub-I and one of the chief residents and a faculty member left some negative professionalism comments on my evals (nothing major, just about asking questions out of place and hence limited interpersonal skills). Most of my other evaluations were positive and honors but my PD did come meet with me during the rotation to voice their concern.

So my sub-I has ended now and I met with PD recently to talk about my chances for my home program given my performance. PD indicated that they only take students who signal and if I were to signal I would be interviewed, but if I did not signal, I wouldn't be considered at all. I further asked about my chances of being ranked and the PD said that I will definitely be interviewed if I signal but cannot give further information.

As most of the faculty and the chief residents at my home program play a key role in ranking applicants, I am wondering if I should signal to get the guaranteed interview but risk being ranked low/DNR or alternatively, not signal at all and use the signal on somewhere else where I have a clean slate, since I am limited to only 10 - 15 signals. Thanks!
You’re telling me your PD is meeting with you because you miss-timed questions? Anyways, maybe you’re not looking for feedback there…

In regards to your PD signal situation, it’s a tough one. I am just going to speculate and there’s a good chance I’m wrong…(and looking above I’m already in the minority here)

I think the PD would have hinted/swayed you from applying if you were that bad even if he or she is usually tight lipped you can usually feel or see it in their eyes. There’s also a chance you improved and I think it’s better to have a known candidate with known (manageable) flaws than have someone new whose flaws are yet to declare themselves. It truly depends how competitive the program is.

If you think despite the SubI, you’re competitive for your home program, then rank it and express humility. It’s 1/15 signals. I would use one on your home program…unless you really think you’re getting 15 other interviews or think the PD doesn’t like you. It’s hard to tell without being there tbh.
 
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You’re telling me your PD is meeting with you because you miss-timed questions? Anyways, maybe you’re not looking for feedback there…

In regards to your PD signal situation, it’s a tough one. I am just going to speculate and there’s a good chance I’m wrong…(and looking above I’m already in the minority here)

I think the PD would have hinted/swayed you from applying if you were that bad even if he or she is usually tight lipped you can usually feel or see it in their eyes. There’s also a chance you improved and I think it’s better to have a known candidate with known (manageable) flaws than have someone new whose flaws are yet to declare themselves. It truly depends how competitive the program is.

If you think despite the SubI, you’re competitive for your home program, then rank it and express humility. It’s 1/15 signals. I would use one on your home program…unless you really think you’re getting 15 other interviews or think the PD doesn’t like you. It’s hard to tell without being there tbh.
The PD is also the CD and had to give required weekly feedback sessions, and the feedback on miss-timed questions did come up early on.

I did get later feedback that I drastically improved from others I worked with, but the initial feedback were negative comments from the chief resident and one of the faculty (who I did not get to work with again but will probably be reviewing residency apps) citing lack of professionalism due to miss-timed questions.
 
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Forgot to mention that my PD requires everyone to signal (even home applicants who WOW everyone) for an interview but interviews are not guaranteed to all who signal (but may be guaranteed to home applicants who signal regardless of profile).

Still, it sounds like I shouldn't apply to my home program then and look elsewhere?
If I were you, I will spend that signal and take Interview. Not getting home program Interview I can’t think of. On another note, when I was applicant last year, my home PD specifically asked not to spend signal for home. Said they will interview home students without signal. Irrespective no PD can give confirmed Yes, that they will rank you higher. So they had to dodge that question.
 
If I were you, I will spend that signal and take Interview. Not getting home program Interview I can’t think of. On another note, when I was applicant last year, my home PD specifically asked not to spend signal for home. Said they will interview home students without signal. Irrespective no PD can give confirmed Yes, that they will rank you higher. So they had to dodge that question.
Actually, a program is free to tell an applicant whatever they want to tell them, just like an applicant can tell a program "I'm ranking you number 1." What isn't allowed is asking how you will be ranked (which it seems like the OP did...).

In general, I think most evals from faculty in a specialty of interest are going to be over-the-top glowing, and the presence of any negative comments sticks out like a sore thumb. Maybe the PD is just cagey, or was put off by the fact that the OP asked explicitly about the chances of being ranked, but I think most programs (though maybe not all) make it clear when they are really interested in keeping someone. In this case, it would be helpful to talk to residents in your home program who came from your school. When they rotated, what kind of feedback did they get? If they got some negative/constructive feedback but still matched, then you can know this is just how this PD rolls; if on the other hand that resident got glowing evals while you got these less good evals, then I think that tells you a lot too.
 
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Ok I guess that could change things. I guess I could get why a home program would want a signal from their students (I really want to stay and I'm not just expecting a courtesy interview). However, I find it not in the best interest of program/school in general to operate that way since you are potentially 'wasting' a signal you could use for one more program elsewhere, and schools should want to give their students the best chance at matching in general.
 
I find it not in the best interest of program/school in general to operate that way since you are potentially 'wasting' a signal you could use for one more program elsewhere, and schools should want to give their students the best chance at matching in general.
Although this is true, ERAS is trying to be equitable. Many residency applicants don't have a home program. If home programs didn't require signals from their students, then those students get an "extra signal". Personally I don't think this changes much, especially as the trend is to give applicants more signals (i.e. 16 vs 15 makes no difference).
 
I guess I'm a bit 'old school' on this one in that if I worked my ass off and got into a place like Harvard as an example, I feel I should get the benefit of interviewing at their home program without using a signal. Trying to even the playing field makes sense though I suppose.
 
I’m just an M4 but if I were you I’d say **** it and just signal to the home program. Worst that can happen is they don’t rank you despite the signal but unless you are more confident about your chances elsewhere I wouldn’t consider this a waste of signal which you get 15 anyways. You may have done not so hot on your sub-I but you never know what can happen. I’ve seen people not able to match a competitive surgical spot but home program offered them a prelim spot and they go on to do well, that I’m certain they wouldn’t have gotten if they didn’t interview with home program. Keep your chin up and shoot your shot.
 
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I’m just an M4 but if I were you I’d say **** it and just signal to the home program. Worst that can happen is they don’t rank you despite the signal but unless you are more confident about your chances elsewhere I wouldn’t consider this a waste of signal which you get 15 anyways. You may have done not so hot on your sub-I but you never know what can happen. I’ve seen people not able to match a competitive surgical spot but home program offered them a prelim spot and they go on to do well, that I’m certain they wouldn’t have gotten if they didn’t interview with home program. Keep your chin up and shoot your shot.
There is a community program affliated with my home institution that I am still conflicted about signaling, and I rotated in a related specialty there and worked with two residents in my intended specialty there who gave me good evals (my CD there (in related specialty) also wrote me a stellar LoR (waived rights but messaged me the details anyways)).

I do think my chances there could definitely be higher than my home academic program (hence signal instead of home program?) but even if interviewed (and I think they interview most/match at least someone from my school each year), I would probably rank it dead last given that the program is still ACGME accredited, it is very underfunded and the residents are forced to do many rotations elsewhere. Still, I would prefer to match at that community program than not match at all.
 
Hi, USMD applying into a moderately competitive specialty this year (80s% match rate for USMDs) and while I have average/above average grades/step for the specialty, in no ways am guaranteed to match. Still, I unfortunately did not do the best on my home sub-I and one of the chief residents and a faculty member left some negative professionalism comments on my evals (nothing major, just about asking questions out of place and hence limited interpersonal skills). Most of my other evaluations were positive and honors but my PD did come meet with me during the rotation to voice their concern.

So my sub-I has ended now and I met with PD recently to talk about my chances for my home program given my performance. PD indicated that they only take students who signal and if I were to signal I would be interviewed, but if I did not signal, I wouldn't be considered at all. I further asked about my chances of being ranked and the PD said that I will definitely be interviewed if I signal but cannot give further information.

As most of the faculty and the chief residents at my home program play a key role in ranking applicants, I am wondering if I should signal to get the guaranteed interview but risk being ranked low/DNR or alternatively, not signal at all and use the signal on somewhere else where I have a clean slate, since I am limited to only 10 - 15 signals. Thanks!
Is this gen surg? Sounds like gen surg. In my experience, it's challenging to take on the med student role without rubbing at least one person the wrong way at some point. In gen surg, this is way more likely, especially as a sub-I. This is why aways are sometimes encouraged and sometimes avoided.

Your role is undefined. You are less useful than a sub-I in non-surgical specialties because you spend time in the OR instead of on the floor where you could actually get things done and make resident's lives easier. The residents are more overworked and crankier than in other specialties. The specialty attracts a certain type of personality that can be difficult to navigate.

Also, just going to throw out that unless you are interrupting people, talking while a patient is bleeding out/crashing, or asking pointless questions on rounds when everyone is obviously trying to get done, there's not a ton you can do to win the "interpersonal skills" game as a med student. Obviously you can increase your odds with some social savvy, but in reality you can only hope to get reasonable people on your team who are supportive. Your social status is so suppressed that anything you do could be perceived the wrong way, and there will be absolutely no mercy or understanding. You will never be seen as a social equal to the residents because med students are so infantilized. Many of these residents want to sh** on someone beneath them. It happens in all hierarchical environments. Even in the lab, a relatively stress-free environment compared to the hospital, there was always a solid 20% of older students who just couldn't help themselves from power-tripping on younger students or simply picking favorites based on demographics, looks, or having the same toxic personality. As part of the 80%, it was frustrating, and there wasn't much I could do to help the students who received the brunt of these miserable individuals.

I'm not saying I'm a social genius, but I was self-aware enough to honor all my rotations and get top scores clinically from both residents and attendings. Gen surg is the only specialty where I consistently encountered such toxic personalities. It's basically this phenomenon, but when people are working 100-hour weeks, residents are often just looking for someone to hate for no reason. Maybe you look like their ex. Maybe they're a little racist. Maybe you're friendly with someone else they hate. There's so much pettiness, and as the lowest rung on the totem pole, unfortunately you just have to accept it.

It doesn't sound like you have a real shot at your home program, and I'm not sure you want to be there anyway.
 
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