SOAP 2015 thread making me nervous

[NickNaylor]

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how so? you don't think hearing that someone loves a program might make a program move a candidate up even one spot possibly?

Maybe it does, maybe it doesn't, but people should ranked according to their preference (and excitement for the program certainly may play a role in that for some people). If the person wants to go to the program then great - they will likely rank the program highly and match there. If not, then they will rank the program low and likely match somewhere else. This will sort itself out without any changes on the part of the program's ROL.

At my home program for my specialty, our advisor admitted that even if you told the program you were going to rank them #1, it would more than likely have no impact at all on their ranking of you. At most it might bump you up a spot or two, but it's not going to move you to ranked-to-match territory if you aren't there already.

 

[SLC]

how so? you don't think hearing that someone loves a program might make a program move a candidate up even one spot possibly?

Exactly, if a program's goal is to match as many enthusiastic candidates as possible, knowing how the algorithm works, this is a solid strategy to make that happen.

One PD's words I remember very well were something like:

"I only interview people I would be (on paper) comfortable ranking at the top of my list, I interview a bunch of excellent candidates each year. Obviously I can't rank them all that way, someone's going to land at the top and someone else has to be at the bottom, so what I want is to know who of those candidates really wants my program too. Those are the people I intend to place at the top of my list. So if you want to be here, you need to let us know."

He then proceeded to tell me that he wasn't there to ask me questions, because he knew he would rank me highly, he wanted to take the time in the interview to sell his program instead. It was a 1.25 hour sales pitch. The whole day was like that.

I didn't give them the communication they sought, placed them second to last on my list (sorta didn't want to even rank them), and didn't match with them.

I'm not upset, I didn't expect to match there and I am honestly glad I didn't. That program and the one on the end of my list were not for me and I dodged a major bullet when I didn't land there. Which is another mistake I made that I lucked out on. Don't rank programs you want absolutely nothing to do with. I fared 100x better in the SOAP than I would have had I matched to one of those last two or three programs. Better than even my top program though the difference is not that great.

 

[Baron Samedi]

Steps to success:
1. Pass all your rotations
2. Pass Step 1 and Step 2
3. Be realistic about your expectations for residency programs

Do all of the above and you won't have to worry about SOAP.

 

[DokterMom]

At my home program for my specialty, our advisor admitted that even if you told the program you were going to rank them #1, it would more than likely have no impact at all on their ranking of you. At most it might bump you up a spot or two, but it's not going to move you to ranked-to-match territory if you aren't there already.

We're pretty much in agreement I think. What I'm saying is that 'all other things being equal' PDs would probably prefer a residency candidate that is excited to be there over one that is there reluctantly. But that's 'all things being equal', and we don't really know how often that happens.

And even then, the only time that will matter is where a program fills right below the 'excited' applicant and right above the 'reluctant' one

 

[SLC]

Steps to success:
1. Pass all your rotations
2. Pass Step 1 and Step 2
3. Be realistic about your expectations for residency programs

Do all of the above and you won't have to worry about SOAP.

Not always true. I did all 3, still SOAP'd

 

[Baron Samedi]

Not always true. I did all 3, still SOAP'd

Other people (like me) get to the point where they think (perhaps erroneously) that some arbitrary number of interviews is enough and stop going on others. There were probably 12-14 interviews I didn't go on because I was feeling good with the ones I had and didn't think I could afford to keep traveling.

False.

 

[Psai]

It is, it's called "hedging your bets". They know that if they have applicants telling them they're ranking them highly, they have a high chance of getting those same applicants if they reciprocate. It's a desire to fill with people who are actually excited to be there.

If your strategy was to only interview folks who you were already very excited about on paper; then ideally fill with the ones who were most excited to join your team, this strategy makes perfect sense. As long as the applicants are honest with you, you can basically all but guarantee yourself a good outcome.

Do you have any idea how the match works? Excitement? Who cares? PDs want people who are competent, hard working and fit well. All those bs love letters are garbage

For the match, you list the programs that you want to match at in that order. If you want to match at a great program, rank the great programs high. It doesn't matter if you put a program that you hated at #1 or #15 if that program picked you and none of the others did. There is literally no difference in the chance at matching because of how the algorithm works.

Similarly, PDs will do best by matching the people they want in that order. There is absolutely no benefit to picking people who are enthusiastic and "want to be there". Everyone who interviewed and ranked them highly want to be there. So PDs will make their list in the order that they want people, with the smart people that will mesh well with the people at the institution at the top. It makes no sense to put in "excited" people just because they are "excited" jesus christ

 

[SLC]

Do you have any idea how the match works? Excitement? Who cares? PDs want people who are competent, hard working and fit well. All those bs love letters are garbage

For the match, you list the programs that you want to match at in that order. If you want to match at a great program, rank the great programs high. It doesn't matter if you put a program that you hated at #1 or #15 if that program picked you and none of the others did. There is literally no difference in the chance at matching because of how the algorithm works. Similarly, PDs will do best by matching the people they want in that order. There is absolutely no benefit to picking people who are enthusiastic and "want to be there". Everyone who interviewed and ranked them highly want to be there. So PDs will make their list in the order that they want people, with the smart people that will mesh well with the people at the institution at the top. It makes no sense to put in "excited" people just because they are "excited" jesus christ

Yeah, you need to read the thread more. Specifically where I stated that the one program I specifically quoted told me about how they don't interview people who they aren't confident would be "competent"

 

[SLC]

False.

Not false, 9-10 interviews is pretty standardly accepted as "adequate". Should I have gone on more? Perhaps, but I was advised to shoot for 9-10 ranks.

 

[Baron Samedi]

Not false, 9-10 interviews is pretty standards u accepted as "adequate". Should I have gone on more? Perhaps, but I was advised to shoot for 9-10 ranks.

Just because you were advised to do something, that doesn't mean it was the correct choice. Obviously it wasn't, because you didn't match. If you had attended the 14 interviews that you blew off, you probably would have matched. You had unrealistic expectations and overvalued yourself as a candidate and as a result, got burnt. The proof is in the pudding, and by pudding I mean SOAP.

 

[PL198]

Not false, 9-10 interviews is pretty standardly accepted as "adequate". Should I have gone on more? Perhaps, but I was advised to shoot for 9-10 ranks.

did you have any bottom of the barrel programs in that 10? like personally when I'm doing mine, I'm going to have 1-2 programs on it that are like solely DO and IMG that I know would be thrilled to get an MD, just so I have literally no worry of SOAP.

 

[Baron Samedi]

did you have any bottom of the barrel programs in that 10? like personally when I'm doing mine, I'm going to have 1-2 programs on it that are like solely DO and IMG that I know would be thrilled to get an MD, just so I have literally no worry of SOAP.

Rank your top choices, programs you would be happy attending, and then the tricky part -- deciding whether you'd rather match in your field of choice in a low-tier program OR take your chances with the SOAP and potentially end up doing another specialty. Regardless, apply broadly and schedule as many interviews as feasible. Sometimes those "bottom of the barrel" programs have a surprising amount to offer.

 

[SLC]

Just because you were advised to do something, that doesn't mean it was the correct choice. Obviously it wasn't, because you didn't match. If you had attended the 14 interviews that you blew off, you probably would have matched. You had unrealistic expectations and overvalued yourself as a candidate and as a result, got burnt. The proof is in the pudding, and by pudding I mean SOAP.

Fair enough. But the NRMP charting outcomes documents even said that the average matched applicant in my field ranked 8, unmatched ranked 5. I had above average step scores by 10+ points, excellent letters, and plenty of invites. Ranked 9 programs. Mathematically I should have been good to go. I don't think I necessarily "overvalued" myself, but I certainly felt confident that I had interviewed at the right places. I'm not sure how I was supposed to know differently.

 

[SLC]

did you have any bottom of the barrel programs in that 10? like personally when I'm doing mine, I'm going to have 1-2 programs on it that are like solely DO and IMG that I know would be thrilled to get an MD, just so I have literally no worry of SOAP.

I feel like the bottom 4 or 5 were pretty poor programs.

 

[PL198]

I feel like the bottom 4 or 5 were pretty poor programs.

that doesn't really compute in terms of not matching then.

 

[SLC]

that doesn't really compute in terms of not matching then.

Poor program might not equate to not-competitive. All my ranks were out west except 2. In SOAP, the west had less than 10% of the un-filled programs, and none of the programs I ranked were unfilled (which would have been a real slap in the face). The Midwest and east coast had more than 90% of the unfilled programs in this field. Perhaps the west was just really competitive across the spectrum of program quality in FM this year?

I don't really know what happened. All I know is I'm pleased with my match now, and while I'm surprised I went unmatched, it ended OK and I entered this thread to let people know that SOAP doesn't have to be the end of the world. If you're a good applicant but end up in SOAP, you'll still get a good spot most likely. There were plenty of good ones still available.

 

[pharmolu]

Sometimes people interview somewhere and start to realize they don't want anything to do with that program for one reason or another. They might decide not to rank them as a result.

Other people (like me) get to the point where they think (perhaps erroneously) that some arbitrary number of interviews is enough and stop going on others. There were probably 12-14 interviews I didn't go on because I was feeling good with the ones I had and didn't think I could afford to keep traveling.

You can rank places you don't interview at, but it's pointless as they won't be ranking you!

You can rank whatever programs you want, but you will not be ranked by programs that you didn't interview at.

And yes, there are people that do not rank programs they interview at. This is recommended if you would rather SOAP or risk not being matched for a year rather than end up at one of those programs. Obviously the reasons for not ranking a program should be pretty compelling given the stakes. It also depends on other things, e.g., field you're applying into, overall goals, strength of your application, etc..

Got it, thanks. Yeah, I assumed that ranking program one didn't interview at was pointless. @SLC I know this doesn't offer much solace from an premed, but I honestly can sympathize with you. I think one of the major differences from the med school application and residency process is after one is holding an acceptance, he/she can be more choosy with what interviews to attend. In the residency process, its difficult to really know where one stands until the email a week before match day, and then its a 'if you're reading this it's too late' scenario.

 

[Psai]

Poor program might not equate to not-competitive. All my ranks were out west except 2. In SOAP, the west had less than 10% of the un-filled programs, and none of the programs I ranked were unfilled (which would have been a real slap in the face). The Midwest and east coast had more than 90% of the unfilled programs in this field. Perhaps the west was just really competitive across the spectrum of program quality in FM this year?

I don't really know what happened. All I know is I'm pleased with my match now, and while I'm surprised I went unmatched, it ended OK and I entered this thread to let people know that SOAP doesn't have to be the end of the world. If you're a good applicant but end up in SOAP, you'll still get a good spot most likely. There were plenty of good ones still available.

You are a case study for rationalization

 

[WingedOx]

You are a case study for rationalization

He's not totally wrong on those points (despite having an inexcusably awful understanding of the match algorithm,) but the number of specialties that you can SOAP into and still turn out ok declines every year.

 

[SLC]

He's not totally wrong on those points (despite having an inexcusably awful understanding of the match algorithm,) but the number of specialties that you can SOAP into and still turn out ok declines every year.

I understand the algorithm fine thank you! You rank where you want to go as your first choice, period. If you don't match there, the algorithm treats your #2 like it was your #1 and tries to match you there, and so on and so forth until you are matched (or not).

There are a million videos explaining this on both the NRMP site and elsewhere. I based my rank list on this understanding.

My whole point this entire time was to relate what I was told by PD's who may or may not have understood the algorithm. I didn't send a love letter, while other applicants surely did, I fully believe this affected my rank position.

I got the impression that some of the PD's I interviewed wanted to know who was going to rank them high, so they could somewhat build their match list to reflect that. That could have been a lie on their part, but I didn't get the feeling it was. I'm not sure why this seems to bother a few of you so badly.

It isn't a difficult concept to understand...

 

[SLC]

You are a case study for rationalization

Glad I could be of assistance 😉

I'll keep my interpretation of you to myself...

 

[randomcollusion]

I've tried to be as open as possible about my match failure because I don't want what happened to me to happen to anyone else. What I've learned is:

Don't completely trust your advisor(s) about your application competitiveness and strategy, do the math yourself and pay attention if there's a discrepancy between what's happening to you and what's happening to everyone else before the application cycle closes.

If you've failed anything, even if it was a preclinical course and your rotations were fine, that's a red flag. You need a backup plan like IM if you're going for any specialty.

If your grades aren't stellar but you have a good Step 1 score, you need a good Step 2 score in case you don't match.

 

[Doug Underhill]

I'm not worried about how bad it is in 2015. I'm worried about how bad it will be in 2019 when I actually have to go through the process with a bazillion dollars in student loan debt. Right now, as a pre-med, all I have is some very manageable undergrad debt. The prospect of not getting into medical school is bad, but it's not life-ruining, and it happens to a lot of great people. There would be disappointment, but I could do another job in this field and still have a decent quality of life with an OK salary.

On the other hand, the prospect of not matching is infinitely worse. If I'm saddled with the US average of $166,750- and I'll probably have more because my state isn't all that great for cheap in-state med schools- and you don't match- what will I do then? What if it becomes a lot harder to get a residency in 2019, just like how it became much, much harder for law grads to find lawyer jobs or for biology Ph.Ds to get tenure-track faculty positions?

 

[NickNaylor]

I'm not worried about how bad it is in 2015. I'm worried about how bad it will be in 2019 when I actually have to go through the process with a bazillion dollars in student loan debt. Right now, as a pre-med, all I have is some very manageable undergrad debt. The prospect of not getting into medical school is bad, but it's not life-ruining, and it happens to a lot of great people. There would be disappointment, but I could do another job in this field and still have a decent quality of life with an OK salary.

On the other hand, the prospect of not matching is infinitely worse. If I'm saddled with the US average of $166,750- and I'll probably have more because my state isn't all that great for cheap in-state med schools- and you don't match- what will I do then? What if it becomes a lot harder to get a residency in 2019, just like how it became much, much harder for law grads to find lawyer jobs or for biology Ph.Ds to get tenure-track faculty positions?

~95% of people match. This really isn't something you or any other pre-med should actually be worried about. Provided you're somewhat intelligent and are able to assess yourself honestly when the time comes (and, thus, you don't apply stupidly), you will almost certainly be fine.

 

[randomcollusion]

Arguably the greater number of sob stories is actually an effect of the increased total applicant number. With a stable failure rate, more people will be part of that 5%. Which is really of no concern to prospective students.

 

[nottooshabby91]

There seems to be a lot of confusion about what the match algorithm does and doesn't do.

One thing it certainly fails to take into account is the level of interest or enthusiasm either party has for the other. Many programs would, other things being equal, prefer to have candidates who have a great deal of enthusiasm for going there, and many candidates would, other things being equal, prefer to be in a program that is enthusiastic about them. In virtually all other graduate programs, such interest and enthusiasm is considered an important ingredient in the desirability of a student, and vice versa.

Why would most medical residency programs wish to have a resident who got matched with their program only as a desperate backup, almost no matter how good otherwise he was? Getting such a student might well not serve larger purposes, such as training residents who would stay in the area, or who would gladly pursue the research and clinical goals of that program. Knowing the level of interest a student has for the program would, rightly, greatly impact how high the program would rank the student. Similar arguments apply in the other direction.

 

[mehc012]

There seems to be a lot of confusion about what the match algorithm does and doesn't do.

One thing it certainly fails to take into account is the level of interest or enthusiasm either party has for the other. Many programs would, other things being equal, prefer to have candidates who have a great deal of enthusiasm for going there, and many candidates would, other things being equal, prefer to be in a program that is enthusiastic about them. In virtually all other graduate programs, such interest and enthusiasm is considered an important ingredient in the desirability of a student, and vice versa.

Why would most medical residency programs wish to have a resident who got matched with their program only as a desperate backup, almost no matter how good otherwise he was? Getting such a student might well not serve larger purposes, such as training residents who would stay in the area, or who would gladly pursue the research and clinical goals of that program. Knowing the level of interest a student has for the program would, rightly, greatly impact how high the program would rank the student. Similar arguments apply in the other direction.

It takes it into account...in the applicant's ranking of the school.

 

[tiedyeddog]

There seems to be a lot of confusion about what the match algorithm does and doesn't do.

One thing it certainly fails to take into account is the level of interest or enthusiasm either party has for the other. Many programs would, other things being equal, prefer to have candidates who have a great deal of enthusiasm for going there, and many candidates would, other things being equal, prefer to be in a program that is enthusiastic about them. In virtually all other graduate programs, such interest and enthusiasm is considered an important ingredient in the desirability of a student, and vice versa.

Why would most medical residency programs wish to have a resident who got matched with their program only as a desperate backup, almost no matter how good otherwise he was? Getting such a student might well not serve larger purposes, such as training residents who would stay in the area, or who would gladly pursue the research and clinical goals of that program. Knowing the level of interest a student has for the program would, rightly, greatly impact how high the program would rank the student. Similar arguments apply in the other direction.

As SS does, it DOES take interest into account on the applicants rank list. Additionally, applicants often self-select geographically by what regions they apply to and where they actually interview. You have to understand that an applicant could easily fake interest or fake the need to be in a geographical area at every single one of their interviews, making it useless to do so. In fact we do see this, as people often spam programs with mail post-interview saying the generic "oh, I luv u the best, I want to be at ur program <3" to every single program on their rank list.

I would say residencies don't disregard interest totally. At most interviews people ask why you applied there, if you could be happy there, what you're looking for in a program. All of these questions gauge interest.

 

[nottooshabby91]

People here are just confused about the point of interest and enthusiasm.

A program might well rank the same candidate either high or low, depending on how enthusiastic that candidate actually is. They have all kinds of good reasons to take enthusiasm and interest into account, as I pointed out -- greater interest in a program indicates that the candidate is more likely to align themselves with the goals of thee program, more likely to stay in the area (obviously of particularly great importance to, say, programs in out of the way places whose mission is to train physicians to serve in that area). The match process has no direct way of controlling for this. A program may well rank a very highly qualified candidate very high, and that candidate might rank that program as the last place he would choose to go, yet have that option as the only one available to him after the matching process. Had the program known how low the candidate had ranked it, it might very reasonably have chosen a somewhat less qualified but more enthusiastic candidate over him.

The match process has its very real defects and this is one. It's not magic.

Obviously, there is some problem in knowing how genuine an expression of interest from a candidate actually is in any case. But the match process simply doesn't capture the level of interest variable in any effective way.

 

[2010houston]

I will echo what SLC said above from my experiences interviewing last year-- there are a few programs out there who very specifically wanted you to let them know if they were at the top of your list, specifically your #1, and made it clear that this would affect your rank on their list. Does this make sense? No. Is it ridiculously silly on the program's part? Yes. Also possibly a match violation on their part, right? Nonetheless, there are a few sketchy programs that indeed do it. So if anyone is misunderstanding the match algorithm it's these odd PDs (and not SLC).

 

[mehc012]

People here are just confused about the point of interest and enthusiasm.

A program might well rank the same candidate either high or low, depending on how enthusiastic that candidate actually is. They have all kinds of good reasons to take enthusiasm and interest into account, as I pointed out -- greater interest in a program indicates that the candidate is more likely to align themselves with the goals of thee program, more likely to stay in the area (obviously of particularly great importance to, say, programs in out of the way places whose mission is to train physicians to serve in that area). The match process has no direct way of controlling for this. It may well rank a very highly qualified candidate very high, and that candidate might rank that program as the last place he would choose to go, yet have that option as the only one available to him after the matching process. Had the program known how low the candidate had ranked it, it might very reasonably have chosen a somewhat less qualified but more enthusiastic candidate over him.

The match process has its very real defects and this is one. It's not magic.

Obviously, there is some problem in knowing how genuine an expression of interest from a candidate actually is in any case. But the match process simply doesn't capture the level of interest variable in any effective way.

OK, sure, you can pretend that enthusiasm is a proxy for all of those aspects, or you could consider "is a good match for the program goals" and "seems likely to stay in the area" as their own criteria, for which interest is vaguely correlated and often inaccurate.

 

[tiedyeddog]

People here are just confused about the point of interest and enthusiasm.

A program might well rank the same candidate either high or low, depending on how enthusiastic that candidate actually is. They have all kinds of good reasons to take enthusiasm and interest into account, as I pointed out -- greater interest in a program indicates that the candidate is more likely to align themselves with the goals of thee program, more likely to stay in the area (obviously of particularly great importance to, say, programs in out of the way places whose mission is to train physicians to serve in that area). The match process has no direct way of controlling for this. It may well match a very highly qualified candidate very high, and that candidate might have that program as the last place he would choose to go, yet have that option as the only one available to him after the matching process. Had the program known how low the candidate had ranked it, it might very reasonably have chosen a somewhat less qualified but more enthusiastic candidate over him.

The match process has its very real defects and this is one. It's not magic.

Obviously, there is some problem in knowing how genuine an expression of interest from a candidate actually is in any case. But the match process simply doesn't capture the level of interest variable in any effective way.

Ok, how do fields outside of medicine trying to competitively higher applicants screen for interest then?

I will echo what SLC said above from my experiences interviewing last year-- there are a few programs out there who very specifically wanted you to let them know if they were at the top of your list, specifically your #1, and made it clear that this would affect your rank on their list. Does this make sense? No. Is it ridiculously silly on the program's part? Yes. Also possibly a match violation on their part, right? Nonetheless, there are a few sketchy programs that indeed do it. So if anyone is misunderstanding the match algorithm it's these odd PDs (and not SLC).

For sure is a match violation to demand to know where you have been ranked on the others list.

 

[gyngyn]

Obviously, there is some problem in knowing how genuine an expression of interest from a candidate actually is in any case. But the match process simply doesn't capture the level of interest variable in any effective way.

There have been Program directors who, in their "genuine interest" to know the applicant's enthusiasm for the program have asked where the candidate planned to rank them. This is what is known as a match violation.

Dang kids type so fast, @2010houston and @tiedyedog beat me to it!

 

[mehc012]

The Rank Order List is the ultimate level of interest variable.

Well, only if the applicants understand how the process works, which doesn't seem like a given...

 

[nottooshabby91]

I will echo what SLC said above from my experiences interviewing last year-- there are a few programs out there who very specifically wanted you to let them know if they were at the top of your list, specifically your #1, and made it clear that this would affect your rank on their list. Does this make sense? No. Is it ridiculously silly on the program's part? Yes. Also possibly a match violation on their part, right? Nonetheless, there are a few sketchy programs that indeed do it. So if anyone is misunderstanding the match algorithm it's these odd PDs (and not SLC).

I won't pretend to know whether these moves on the part of the programs is or is not a match violation. But their desire for this information -- whether a candidate ranks the program very high -- couldn't be more rational. Many programs have a strong inherent need to know that the candidates they select aren't going there only as a last resort, as I argued.

In fact, I'm sure that this sort of consideration always crops up anyway -- many programs very much want to know, for example, why you might want to move to a certain area, and why you might want to stay, and will rank low, or not at all, candidates who produce no such plausible reason. The very best signal for that sort of interest would be a very high ranking from a candidate -- which they are of course generally discouraged by the match process from conveying.

 

[gyngyn]

Well, only if the applicants understand how the process works, which doesn't seem like a given...

It's very simple (except for the couples match). You rank them in the order that you prefer them.
The algorithm starts with the candidate's preferences.

 

[mehc012]

It's very simple (except for the couples match). You rank them in the order that you prefer them.

Lol, yes...however, SDN gives the impression (whether accurate or not) that it's not terribly uncommon for people to just *not* get that, though. Comments like 'it is risky ranking [hard to get into program] as #1" or stories about people trying to game the system by ranking schools that like them more, etc, crop up here and there. Heck, this thread makes it seem as if some PDs aren't fully familiar with the setup.

 

[nottooshabby91]

The Rank Order List is the ultimate level of interest variable.

Yes, this is actually quite true -- but, from what I understand, the problem is that the match process actively discourages the communication of that rank order before each side fills out its rank list. By design, each side is in the dark as to what the other side has actually chosen.

 

[mehc012]

Yes, this is actually quite true -- but, from what I understand, the problem is that the match process actively discourages the communication of that rank order before each side fills out its rank list. By design, each side is in the dark as to what the other side has actually chosen.

But it's still taken into account when making the matches, and without the programs having to do so themselves.

 

[tiedyeddog]

I won't pretend to know whether these moves on the part of the programs is or is not a match violation. But their desire for this information -- whether a candidate ranks the program very high -- couldn't be more rational. Many programs have a strong inherent need to know that the candidates they select aren't going there only as a last resort, as I argued.

In fact, I'm sure that this sort of consideration always crops up anyway -- many programs very much want to know, for example, why you might want to move to a certain area, and why you might want to stay, and will rank low, or not at all, candidates who produce no such plausible reason. The very best signal for that sort of interest would be a very high ranking from a candidate -- which they are of course generally discouraged by the match process from conveying.

I think you are overblowing the "last resort thing". Just because a program was ranked last on someone's rank list does not mean that when a person matches at that program they will be worse for the program than someone who ranked the program #1 but was ranked lower by the program. Most people don't interview at or rank programs they have no desire to be at. You are basically equating the success of the applicant to where they matched on their rank list, which is not true most of the time. There are so many more factors that go into picking a successful resident for a program or an applicant picking the best program for him/her.

 

[gyngyn]

Yes, this is actually quite true -- but, from what I understand, the problem is that the match process actively discourages the communication of that rank order before each side fills out its rank list. By design, each side is in the dark as to what the other side has actually chosen.

The applicant is free to inform the program of where they plan to rank them. The match violation is the coercion of that information from the candidate by the program.

 

[tiedyeddog]

One more thing to add in, let me describe two applicants for you.
1. Guy, Step score 240, great third year grades. Applies to program A, B, C, D, E.
2. Girl, Step score 220, mediocre third year grades. Applies to program A, B, C, D, E. Maybe she goes to school at E, doesn't matter.
Each program has 1 spot.

Guy is going to get more interviews. He will get interviews at places than girl because his stats are better. He gets interviews at all 5, A-E. He loves program A, feels alright about B-E.

Girl has worse stats. She only gets an interview to program E.

In the end, here is Guy's ROL: 1- A, 2- B, 3- C, 4- D, 5- E.
Here is girl's: 1- E.

Guy ends up matching at E, Girl goes unmatched.

So, should girl be rewarded for ranking E number 1? Of course not. Is Guy's life going to suck because he matched at E? Thats a personal decision but probably not. But this example is EXACTLY why where you rank a program should have ZERO effect on where a program ranks you.

The reason it is illegal for each member to ask the other where they ranked each other is this: people lie. Applicants lie, program directors lie.

 

[nottooshabby91]

I think you are overblowing the "last resort thing". Just because a program was ranked last on someone's rank list does not mean that when a person matches at that program they will be worse for the program than someone who ranked the program #1 but was ranked lower by the program. Most people don't interview at or rank programs they have no desire to be at. You are basically equating the success of the applicant to where they matched on their rank list, which is not true most of the time. There are so many more factors that go into picking a successful resident for a program or an applicant picking the best program for him/her.

Look, a great many candidates will have a wide range of choices, from those they would love to go to, to those that they will go to only if they have no other options. In fact, it's actually risky and even foolish for many candidates to throw out possibilities unless they are willing to go entirely without a residency in a given year--which very few people are. Obviously a program has a great and legitimate interest in knowing whether the candidate ranks them very high or very low. Again, why should a program even ask whether a candidate has a connection to the region in which it is located, if the match process is so perfect? Why not just rank candidates strictly according to their qualifications, and let the match process do its "magic"? If these programs actually knew for sure how highly the candidate ranks them, wouldn't that tell them how much an obstacle or enticement their location actually is to the candidate?

 

[tiedyeddog]

If these programs actually knew for sure how highly the candidate ranks them, wouldn't that tell them how much an obstacle or enticement their location actually is to the candidate?

No one is saying it's perfect. But I just gave a great example of why programs shouldn't care where they were ranked by applicants. It doesn't matter. There is no more explaining that needs to be done here unless you give a suggestion that is better.

And please explain the part I quoted above. Why should programs care about that? It really doesn't make a difference. You really just aren't understanding how the match works. Go back to the example I laid out for you.

Girl ranked E number 1 out of 1 possible places to match. Guy ranked it 5 out of 5 possible places to match. Presumably they BOTH are OK with going to E, since they placed it on their rank lists. Just because Girl only received one program does NOT mean she should trump Guy.

 

[mehc012]

Beyond the very obvious logistical problems an interest-based mutual ranking could cause (@tiedyeddog gave a good example of this, but also consider the issues you'd run into with people trying to game the system with bizarre rankings, something the current setup explicitly avoids), I have to wonder how many of the concerns being brought up are really relevant to a residency program.

Remember, the vast majority of USMD grads are going to become doctors. While med schools may select for specific goals such as 'increase PCP doctors' or 'recruit people to serve rural TX', by the time you get to residency, that ship has mostly sailed. Residency directors are not culling the pool of future doctors as a whole - they are merely selecting which members of that pool they have to employ/teach/work with for 3-6yrs. The chief goal of a residency program, logically, is to recruit the most capable graduates who will work the hardest, learn the quickest, and reflect well on the program. It's a wholly different setup, and quite frankly I see very few instances where the candidates' interest in the program (vs other programs) is particularly indicative of anything the residency program actually cares about.

 

[nottooshabby91]

The applicant is free to inform the program of where they plan to rank them. The match violation is the coercion of that information from the candidate by the program.

But if a program asks or even hints to a candidate that they would like to know how highly the candidate ranks them, and the candidate refuses to provide an answer, I think the program can pretty reasonably assume that the candidate didn't rank them highly.

So in practice I'm not sure "coercion" makes much of a difference.

 

[mehc012]

But if a program asks or even hints to a candidate that they would like to know how highly the candidate ranks them, and the candidate refuses to provide an answer, I think the program can pretty reasonably assume that the candidate didn't rank them highly.

So in practice I'm not sure "coercion" makes much of a difference.

Which is why, in practice, 'coercion' translates more to 'asking'

 

[nottooshabby91]

One more thing to add in, let me describe two applicants for you.
1. Guy, Step score 240, great third year grades. Applies to program A, B, C, D, E.
2. Girl, Step score 220, mediocre third year grades. Applies to program A, B, C, D, E. Maybe she goes to school at E, doesn't matter.
Each program has 1 spot.

Guy is going to get more interviews. He will get interviews at places than girl because his stats are better. He gets interviews at all 5, A-E. He loves program A, feels alright about B-E.

Girl has worse stats. She only gets an interview to program E.

In the end, here is Guy's ROL: 1- A, 2- B, 3- C, 4- D, 5- E.
Here is girl's: 1- E.

Guy ends up matching at E, Girl goes unmatched.

So, should girl be rewarded for ranking E number 1? Of course not. Is Guy's life going to suck because he matched at E? Thats a personal decision but probably not. But this example is EXACTLY why where you rank a program should have ZERO effect on where a program ranks you.

The reason it is illegal for each member to ask the other where they ranked each other is this: people lie. Applicants lie, program directors lie.

Not sure what you think your example proves. Yes, sometimes the match works fine. My point is that it is often the case that it works badly because it doesn't take into account the real level of interest a candidate has, and that that is very often a crucial variable.

Again, there is a very good reason many programs are desperate to know whether a candidate's interest in a program is deep. That's why many of them will want to understand why you might want to live for 4 years in their area, and then, hopefully, stick around afterwards. The best authentic signal of this would be to know that the candidate ranked them very high. Yet these programs are deliberately not given that information before they compose their own ranked lists, and are forbidden, apparently, to demand it of their candidates.

 

[gyngyn]

But if a program asks or even hints to a candidate that they would like to know how highly the candidate ranks them, and the candidate refuses to provide an answer, I think the program can pretty reasonably assume that the candidate didn't rank them highly.
.

If the PD were allowed to do this, it does raise the specter of coercion, in that a person who failed to tell could suffer retaliation. This is part of the system that the match was designed to negate!

In essence, "show me your ROL or we won't rank you."

 

[DokterMom]

A couple of responses:

As to whether or not the match gets harder and riskier each year -- let's hypothesize that it does. Consider also that the availability of information also gets better each year, and for those applicants who are well-informed (hint: SDNers), they should be able to put that extra information to good use and formulate effective match strategies. Effective match strategies would be identifying any red flags, accurately assessing their own competitiveness, accurately assessing the competitiveness or their desired specialties, factoring in the desirability of their chosen locations, then casting a sufficiently wide net.

Bottom line -- 95% of you will be just fine.

As to the riskiness of ranking super competitive programs first -- The only real risk is that you won't match into your first choice program. But if you've interviewed at your dream program and rank it below #1 for some misguided reason, you only increase the risk that you won't go there.