"Thank you" and "You're my #1" notes to PD's

[lawj]

If a program director tells you "When it comes time to rank, let us know if you are ranking us #1, because only people who express interest in our program will get ranked to match. And once you let us know, we'll let you know". You should then expect a response.

But isn't this statement a violation of the above posted NRMP rules?

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[gutonc]

But isn't this statement a violation of the above posted NRMP rules?

Yes.

That doesn't mean it doesn't happen though.

 

[clement]

So I heard something interesting from another applicant recently while on the IV trail...This applicant had heard that come ranking time, apparently specifying "you are my NUMBER ONE" to programs is all that matters. Anything else you state very likely disregarded. So I don't how to approach numbers 2, 3, 4, and 5.

So when do we declare our love officially after those initial post-interview thank yous? End of Jan? Early Feb? Mid Jan?
Is there a consensus? I think my list will be impacted if I don't get feedback in the form of 3+ pulses from my top 5, s/p official love transfusion.

 

[atsai3]

So I heard something interesting from another applicant recently while on the IV trail...This applicant had heard that come ranking time, apparently specifying "you are my NUMBER ONE" to programs is all that matters. Anything else you state very likely disregarded. So I don't how to approach numbers 2, 3, 4, and 5.

From another thread two weeks ago:

You could try to say something like "you are one of my top 3 choices" or even worse "I will be ranking you very highly", but that won't really make a difference. No program director would hear that statement and think "ooh, maybe this means we'll be her #1 choice". Like I said, you only have 2 plays. "You're my #1" -- or not. The program director knows that you will profess your undying love to your #1 choice, whichever program your #1 choice may be. The program director knows this because applicants exhibit this behavior: universally, applicants will tell their #1 choice "you are my #1 choice" because they think it will induce the program to rank them more highly. (Of course, applicants only do this because everyone else is doing this. Clearly all applicants would be better off if no one professed their love to their respective #1 choices, but this is an unstable equilibrium because any applicant has an incentive to break rank.) The program director also knows that you know that you can (ethically) only profess your undying love to a single program. So when it comes time for you to say something to the program director, she knows that if you do not tell her "you're my #1", then she is not your #1 choice.

So really what you should do is just keep silent. Who cares if the program director says "let's keep in touch", who cares if the program director leaves you a voice mail the day before rank lists are due, etc etc. Sure, this takes cojones -- but you should do this because it is the right thing to do, and if everyone behaved similarly then the Match world would be a better place. (This is not just cheap talk. I did this myself, and things turned out just fine.)​

 

[atsai3]

But isn't this statement a violation of the above posted NRMP rules?

1. I only described a hypothetical. No value judgments as to whether it is or is not a violation of NRMP guidelines.

2. Why do you care if it is a violation of NRMP guidelines? What are you going to do, write your interviewer's supervisor a letter and CC the program director documenting that a violation of NRMP guidelines took place during your interview? My guess is that most people would not.

-AT.

 

[clement]

From another thread two weeks ago:

You could try to say something like "you are one of my top 3 choices" or even worse "I will be ranking you very highly", but that won't really make a difference. No program director would hear that statement and think "ooh, maybe this means we'll be her #1 choice". Like I said, you only have 2 plays. "You're my #1" -- or not. The program director knows that you will profess your undying love to your #1 choice, whichever program your #1 choice may be. The program director knows this because applicants exhibit this behavior: universally, applicants will tell their #1 choice "you are my #1 choice" because they think it will induce the program to rank them more highly. (Of course, applicants only do this because everyone else is doing this. Clearly all applicants would be better off if no one professed their love to their respective #1 choices, but this is an unstable equilibrium because any applicant has an incentive to break rank.) The program director also knows that you know that you can (ethically) only profess your undying love to a single program. So when it comes time for you to say something to the program director, she knows that if you do not tell her "you're my #1", then she is not your #1 choice.

So really what you should do is just keep silent. Who cares if the program director says "let's keep in touch", who cares if the program director leaves you a voice mail the day before rank lists are due, etc etc. Sure, this takes cojones -- but you should do this because it is the right thing to do, and if everyone behaved similarly then the Match world would be a better place. (This is not just cheap talk. I did this myself, and things turned out just fine.)​

Silence is risky. Talk is cheap. It's a no-winner.

If they loved you and you'd didn't so much as give them an inckling of how you perceive their program, that isn't always helpful (I'm talking AVERAGE candidate). There's a reason why THEY hand you their card at interviews and not vice-versa (how awk would that be? I'm sure it's happened). Then if you profess your love, you could be perceived as pathetic by some. It's just all subjective in the end, no? All in all though, there is nothing wrong with individualizing your love and sending it out. Who doesn't love a little non-generic praise?

 

[sintheta]

my worry about sending out 'you're my #1' is if PDs talk to each other. since it's highly possible that one could match at 2nd or 3rd choice, wouldn't it be awkward if you don't match at your #1, and then your #2 knows for the next few years that you WEREn't there #1?

especially awkward if you're #1 choice isn't your home program...and then they find that out...

thoughts on how to handle this? thanks in advance!

 

[stapleit]

my worry about sending out 'you're my #1' is if PDs talk to each other. since it's highly possible that one could match at 2nd or 3rd choice, wouldn't it be awkward if you don't match at your #1, and then your #2 knows for the next few years that you WEREn't there #1?

especially awkward if you're #1 choice isn't your home program...and then they find that out...

thoughts on how to handle this? thanks in advance!

I dont get why this is relevant, unless you told them they were your #1. It's unreasonable to think that home programs expect all their students to make them #1. The only thing that matters is, if you tell a program they're your #1, make sure they really are.

 

[gutonc]

my worry about sending out 'you're my #1' is if PDs talk to each other. since it's highly possible that one could match at 2nd or 3rd choice, wouldn't it be awkward if you don't match at your #1, and then your #2 knows for the next few years that you WEREn't there #1?

especially awkward if you're #1 choice isn't your home program...and then they find that out...

thoughts on how to handle this? thanks in advance!

1. PDs do talk to each other but it's not like there's some massive PD listserv/forum where they all talk about who told them they were going to rank them #1. Besides, if they are talking to each other, it's probably more about plans for adhering to the new duty hours, not whether or not sintheta is going to rank them first.

2. Not ranking your home program 1st is pretty common. I didn't even apply to my home program. Don't worry about it.

 

[sintheta]

1. PDs do talk to each other but it's not like there's some massive PD listserv/forum where they all talk about who told them they were going to rank them #1. Besides, if they are talking to each other, it's probably more about plans for adhering to the new duty hours, not whether or not sintheta is going to rank them first.

2. Not ranking your home program 1st is pretty common. I didn't even apply to my home program. Don't worry about it.

Thanks for this advice, you seriously made me laugh out loud I think I might go for it and tell my non-home-program that they're my #1, wish me luck!

 

[Gordon Sims]

This is for all applicants: do NOT tell every program you go to they are your #1. The problem with this strategy is it can lead to a program--you may not want to be at--ranking you highly. This, of course, can lead to you spending several years in a bad situation. QUOTE]

So now that the above comment has been shown to be not entirely correct by a another poster (i.e. your rank list matters more than the program's regarding placement preference.) What is the real problem, if any, with just sending out blanket "you're my #1 choice" to different programs that you really liked in hopes of getting matched to one of them?

 

[lawj]

So now that the above comment has been shown to be not entirely correct by a another poster (i.e. your rank list matters more than the program's regarding placement preference.) What is the real problem, if any, with just sending out blanket "you're my #1 choice" to different programs that you really liked in hopes of getting matched to one of them?

Besides showing that you lack integrity? I understand where you're coming from though. I struggled with the same question. If I do not match at my number one choice, I didn't want to jeopardize my chances of matching to my number 2 or 3 programs because I did not tell them that they are my number one as well. I've come to the conclusion that lying to the other programs is not worth it, and probably not necessary. My 2 cents.

 

[Ludicolo]

So now that the above comment has been shown to be not entirely correct by a another poster (i.e. your rank list matters more than the program's regarding placement preference.) What is the real problem, if any, with just sending out blanket "you're my #1 choice" to different programs that you really liked in hopes of getting matched to one of them?

The following week after Match day, programs get a list of all of the applicants that they ranked, stating where each of the candidates matched. If you told a program that they were your #1… and they ranked you to match… and you end up elsewhere… the program will know you lied to them. And PDs do talk. Maybe not about this particular scenario on a regular basis, but you never know what – or who – comes up in conversation. The world of academic medicine is small, and we as physicians are trained to memorize minute details over long periods of time.

Could that matter in the future, when it comes time to apply for fellowships, or if you need to switch residencies, or if you’re looking for employment, or if you run into the PD at a regional or national meeting or something? Perhaps.

And yes, the integrity thing. You guys being the future of US medicine and all that.

 

[HemeOncDO]

The following week after Match day, programs get a list of all of the applicants that they ranked, stating where each of the candidates matched. If you told a program that they were your #1… and they ranked you to match… and you end up elsewhere… the program will know you lied to them. And PDs do talk. Maybe not about this particular scenario on a regular basis, but you never know what – or who – comes up in conversation. The world of academic medicine is small, and we as physicians are trained to memorize minute details over long periods of time.

Could that matter in the future, when it comes time to apply for fellowships, or if you need to switch residencies, or if you’re looking for employment, or if you run into the PD at a regional or national meeting or something? Perhaps.

And yes, the integrity thing. You guys being the future of US medicine and all that.

What if you change your mind? For example you've told PD A that they are your 1st choice. Had a few more interviews, now you feel PD 3 is 1st. Then a late interview changed your rank order, or say a family situation made you change your rank order after you've told a PD they were 1st? It isn't a "lie." It was most likely true when you wrote it ( I would hope). Of course if you wait until interview season is over to write to PDs, it would be best. But last minute interviews pop up as well as other situations that might affect your final rank order. That being said, when you receive a hand written card from a PD that says please seriously consider us....is that generic or a good sign?

 

[alwaysaangel]

What if you change your mind? For example you've told PD A that they are your 1st choice. Had a few more interviews, now you feel PD 3 is 1st. Then a late interview changed your rank order, or say a family situation made you change your rank order after you've told a PD they were 1st? It isn't a "lie." It was most likely true when you wrote it ( I would hope). Of course if you wait until interview season is over to write to PDs, it would be best. But last minute interviews pop up as well as other situations that might affect your final rank order.

One of our faculty addressed this. He said if something changes last minute just give him the courtesy of a call or email so he's not surprised come match day. He said one of his greatest pet peeves is when someone says you are their number one and then doesn't match there, he doesn't appreciate going to bat for someone and then not being given the courtesy of "hey my circumstances changed." He told us he remembers it and makes a point to never consider those people for future fellowships.

That being said, when you receive a hand written card from a PD that says please seriously consider us....is that generic or a good sign?

Not good. Not bad. Enjoy feeling wanted but overall they play a game and we play a game. You will never be sure if that program sends those to 1 person or 1000.

 

[Gordon Sims]

The following week after Match day, programs get a list of all of the applicants that they ranked, stating where each of the candidates matched. If you told a program that they were your #1… and they ranked you to match… and you end up elsewhere… the program will know you lied to them. And PDs do talk. Maybe not about this particular scenario on a regular basis, but you never know what – or who – comes up in conversation. The world of academic medicine is small, and we as physicians are trained to memorize minute details over long periods of time.

Could that matter in the future, when it comes time to apply for fellowships, or if you need to switch residencies, or if you’re looking for employment, or if you run into the PD at a regional or national meeting or something? Perhaps.

And yes, the integrity thing. You guys being the future of US medicine and all that.

I'm glad this topic was elaborated upon. Thanks for everyone's input.

 

[slippy22]

Are "number 1" notes sent as letters in the mail. How sure can you be that the PDs read these notes? It seems unlikely that they read all the thank you notes. Well, maybe in small programs that interview 40 people for 4 spots. But in a large program interviewing 500 people for 50 spots, I doubt the PD reads hundreds of thank you notes.

 

[Marianne11]

If you send your #1 card to a program, but hear nothing in return. Isn't in "unlikely" they will rank you to match? Shouldn't you get an email, a card, something? Not hearing from a program can make you change your mind about their rank position. Then do you let an "uninterested program" know they are no longer your #1?

 

[QofQuimica]

I think you folks are seriously overthinking this. You should rank the programs how you like them regardless. Don't read too much into if you get a response, if you don't get a response, if the response is super lovey-dovey, if the response is too impersonal. It's not a cup full of tealeaves, so stop trying to use it to predict the future!

 

[alphaholic06]

I think you folks are seriously overthinking this. You should rank the programs how you like them regardless. Don't read too much into if you get a response, if you don't get a response, if the response is super lovey-dovey, if the response is too impersonal. It's not a cup full of tealeaves, so stop trying to use it to predict the future!

I endorse this post!

 

[slippy22]

I think you folks are seriously overthinking this. You should rank the programs how you like them regardless. Don't read too much into if you get a response, if you don't get a response, if the response is super lovey-dovey, if the response is too impersonal. It's not a cup full of tealeaves, so stop trying to use it to predict the future!

I wasn't saying you should read into not getting a response. I'm just saying you shouldn't assume that because you sent a "number 1" note to a program, they got the message.

 

[Deferoxamine]

So the whole "You're my #1" thing...

If the PD gave me his/her business card and said to email as needed, can a well-written email stating that I am putting them #1 suffice? They'll receive it sooner and I'm (perhaps) slightly more likely to receive something back.

I know this goes against my 1800's mentality expressed earlier (of snail mail or GTFO), but at this stage of the game, I feel like each and every day is important, and I'd prefer not to waste 3 days for my snail mail letter to arrive, followed by the Secretary-who's-out-sick's weeklong delay of getting it to the PD, yadda yadda yadda.

Catch my drift?

 

[ranmyaku]

Then do you let an "uninterested program" know they are no longer your #1?

Yes. You should get a certified letter on your school letterhead. Make sure it says they are no longer your #1. In fact, you should state that you might not be ranking them at all based on their arrogance at not responding to your love card. Be sure and put some hearts at the end.

 

[CardiacIntensivist]

So the whole "You're my #1" thing...

If the PD gave me his/her business card and said to email as needed, can a well-written email stating that I am putting them #1 suffice? They'll receive it sooner and I'm (perhaps) slightly more likely to receive something back.

I know this goes against my 1800's mentality expressed earlier (of snail mail or GTFO), but at this stage of the game, I feel like each and every day is important, and I'd prefer not to waste 3 days for my snail mail letter to arrive, followed by the Secretary-who's-out-sick's weeklong delay of getting it to the PD, yadda yadda yadda.

Catch my drift?

Well I don't know the answer to your question but I am definitely sending an email. The thought of waiting for snail mail and then the chance of it being lost some how irks me. At least with email, I know it got there.

As for people who are over thinking the no response, RELAX. I think PDs and interviewers realize thank you notes are a courtesy and they do not feel the need for the back and forth responses because they realize everyone has better things to do. I know for a fact that my PD dislikes thank you notes, especially if it is a thank you note with a question so that he feels obligated to respond. If they don't respond to your "you're my #1" letter, first of all, why would you be sending it this early anyway? It'll definitely lead to the problems of changing your mind like we saw above. Second, perhaps they have a rule not to let anyone know how they are ranking? Whatever the case, it IS probably just better to rank how you see fit.

Think about it this way, you write a "you're my number 1" letter and get no response. If you match - great, you were probably going to rank there anyway. If you don't, no letter, phone call or begging would've made much difference anyway.

 

[Marianne11]

Yes. You should get a certified letter on your school letterhead. Make sure it says they are no longer your #1. In fact, you should state that you might not be ranking them at all based on their arrogance at not responding to your love card. Be sure and put some hearts at the end.

Is this your sarcastic way of saying that if you change your mind, the PD doesn't need to be notified and it's okay to tell more than 1 PD they are your 1st choice?

 

[stapleit]

what are you guys writing in these notes? just a simple "you're my top choice" or rehashing why you want to go there? I figure the simple version might sound too generic but most PDs don't have time to read an essay either.

blarg.

 

[rachmoninov3]

So the whole "You're my #1" thing...

If the PD gave me his/her business card and said to email as needed, can a well-written email stating that I am putting them #1 suffice? They'll receive it sooner and I'm (perhaps) slightly more likely to receive something back.

I know this goes against my 1800's mentality expressed earlier (of snail mail or GTFO), but at this stage of the game, I feel like each and every day is important, and I'd prefer not to waste 3 days for my snail mail letter to arrive, followed by the Secretary-who's-out-sick's weeklong delay of getting it to the PD, yadda yadda yadda.

Catch my drift?

I love you man, but sometimes...
The PD told you to email, so email. That's it. You're just following instructions. We have very little control in this whole process, and as hard as that is to come to terms with, there is nothing we can do to really change it. Send your email and maybe just maybe it'll make a difference.
Think of this like a job interview: one phone call to follow up and show your interest and that's it. Anything else is just annoying.