What to tell #2?

[BobA]

Here's my situation: I've told my #1 that they are #1, but it's a very competitive program and I don't think it's likely I'll match there.

I think it's much more likely that I could match at my #2.

How can I express strong interest in my #2?

Thanks!

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[Doctor Grim]

Here's my situation: I've told my #1 that they are #1, but it's a very competitive program and I don't think it's likely I'll match there.

I think it's much more likely that I could match at my #2.

How can I express strong interest in my #2?

Thanks!

You tell them they're your #1 as well.

Programs do this all the time.

 

[Law2Doc]

You tell them they're your #1 as well.

Programs do this all the time.

Not if you are ethical you don't. You simply tell them how interested you are in them and how you hope to join them in July. No mention of rank. There isn't really any value in breaking your word -- I doubt any program is going to read anything other than a statement of interest into your letter/email anyhow so why cross this line? Also, the programs will know where you end up matching, and so you burn a bridge if you tell a program they are number 1 and they find out you lied. People have been known to change paths and so it's always best not to get yourself a rep for dishonesty. It's a small profession and you will very likely come across PDs at various conventions down the road.

Part of being a member of a profession is conducting yourself with a certain code of ethics and decorum. You should act like a professional in all career aspects. The argument that "they are lying so you should too" isn't a good one. Two wrongs don't make a right. As a professional you are expected to take the high road.

 

[guitarguy09]

You tell them they're your #1 as well.

Programs do this all the time.

Not cool! I do NOT think it's the same when an applicant tells multiple programs that they are "#1" as opposed to a program saying that they are "ranking you to match". A program may have legitimately ranked a person where they would have matched based on how previous year's matches have gone, but they by chance may not have gone down the list as far usual (and thus the applicant doesn't match there). That being said, I'm sure that some applicants read into the post-interview correspondence that they get from programs a little too much and read "it would be great to have you at our program" as "you're at the top of our rank list" (when that might just mean, "we are ranking you"). I think telling multiple places that they are your #1 is not ethical and may get you burned in the long run when applying for jobs, etc. Why can't you just say that you will rank them "very highly"? They will understand that you are very interested. Why lie?

 

[Doctor Grim]

Not cool! I do NOT think it's the same when an applicant tells multiple programs that they are "#1" as opposed to a program saying that they are "ranking you to match". A program may have legitimately ranked a person where they would have matched based on how previous year's matches have gone, but they by chance may not have gone down the list as far usual (and thus the applicant doesn't match there). That being said, I'm sure that some applicants read into the post-interview correspondence that they get from programs a little too much and read "it would be great to have you at our program" as "you're at the top of our rank list" (when that might just mean, "we are ranking you"). I think telling multiple places that they are your #1 is not ethical and may get you burned in the long run when applying for jobs, etc. Why can't you just say that you will rank them "very highly"? They will understand that you are very interested. Why lie?

I totally agree with your reasons for being ethical. I didn't propose that he tells every single program that they are his #1. His #2 program could be his #1 if he knows that he is unlikely to match at his #1 program.

Let me digress from this topic for a bit. So when an applicant applies for IM, FM, and psych and s/he really wants to do IM, but at the interview for FM and psych, s/he tells his interviewers that s/he really wants to do FM or psych. Is that being unethical? In fact, s/he applied to these two specialties as backups. Wouldn't that mislead the programs into ranking them high if they are seasoned interviewees? And again, you see this all the time in reality.

Programs do send letters telling applicants that they would rank them high in hoping that these applicants in return would also rank them high. So that programs, in less competitive specialties, wouldn't have to deal with scrambles after the match with unfilled open spots.

 

[Law2Doc]

I totally agree with your reasons for being ethical. I didn't propose that he tells every single program that they are his #1. His #2 program could be his #1 if he knows that he is unlikely to match at his #1 program.

That's still dishonest -- saying you are my #1, because you don't think you'll get the program you're ranking higher is still telling your #2 program they are #1 even though you have no intention of ranking them #1. It's an outright lie.

 

[Law2Doc]

...

Let me digress from this topic for a bit. So when an applicant applies for IM, FM, and psych and s/he really wants to do IM, but at the interview for FM and psych, s/he tells his interviewers that s/he really wants to do FM or psych. Is that being unethical? In fact, s/he applied to these two specialties as backups. Wouldn't that mislead the programs into ranking them high if they are seasoned interviewees? And again, you see this all the time in reality.
...

Being misleading is not the same as lying. Saying you like FM because of X, Y and Z is very different than telling a FM program you are ranking them #1. You can like multiple specialties for different reasons, and never have to say you like FM better than IM or psych etc (which would be a lie). So you talk around the issue, and don't pin yourself down to a false statement.

 

[Law2Doc]

...

Programs do send letters telling applicants that they would rank them high in hoping that these applicants in return would also rank them high. ...

Telling a program you will rank them highly is fine (and vice versa). "highly" is subject to definition and nobody is going to think it unreasonable if you really meant 5th instead of 1st. Putting an actual number on it is where you are being dishonest/unethical. So no, don't do this.

 

[BobA]

I appreciate the debate, but I'm not going to tell two programs that I'm ranking them #1. I'm an ethical guy for personal reasons and that's that.

However, I worry about telling a program that I'm going to rank them "very highly" because doesn't that in essence mean "I'm not ranking you #1"?

Is there a stronger way to say "I'm ranking you very highly"?

 

[Law2Doc]

I appreciate the debate, but I'm not going to tell two programs that I'm ranking them #1. I'm an ethical guy for personal reasons and that's that.

However, I worry about telling a program that I'm going to rank them "very highly" because doesn't that in essence mean "I'm not ranking you #1"?

Is there a stronger way to say "I'm ranking you very highly"?

You could just say you hope to see them in July.

 

[John Deere Gree]

You tell them they're your #1 as well.

Programs do this all the time.

And it's people like this that ruin it for the rest of us. No wonder many PDs turn a deaf ear when they hear an applicant say they are their number one choice.

 

[mcl]

I appreciate the debate, but I'm not going to tell two programs that I'm ranking them #1. I'm an ethical guy for personal reasons and that's that.

However, I worry about telling a program that I'm going to rank them "very highly" because doesn't that in essence mean "I'm not ranking you #1"?

Is there a stronger way to say "I'm ranking you very highly"?

You could say that you enjoyed your visit, believe that the program would meet all of your expectations for residency, and that you would be very happy to match there. If you want to sell yourself a little as well as express your interest, you could mention some specific way in which you would be an asset to the program. For example, my program stresses teaching, so an applicant would reiterate how much they look forward to having an opportunity to participate in that aspect of our program.

 

[Doctor Grim]

Having served on the resident selection committee as a chief resident, I can tell you that most likely a decision on whether to rank someone or DNR (do not rank) has been made at the end of the interview date.

A composite score is given for an applicant based on parameters such as credentials, previous experiences, liklihood to succeed, personality, interest in the specialty..etc.

We rank applicants based on the composite score regardless of whether the applicants come back for a second look or not, or if they tell us how much they like us. It is usually irrelevant.

Still, a polite thank you note after the interview is still expected for courtesy.

Occasionally for those highly qualified applicants, we'll go out of our way to let them know that we're interested in them. But this doesn't happen a lot. Some programs do this all the time as a routine.

And we go from there...waiting for the results.

All in all, the NRMP is a joke. It should be like college or fellowship application process where you just apply to places where you think you want to be and hopefully you'll get interviewed and end up with multiple acceptances so that you can decide what is best for you.

Just my 0.02.

 

[dragonfly99]

Having served on the resident selection committee as a chief resident, I can tell you that most likely a decision on whether to rank someone or DNR (do not rank) has been made at the end of the interview date.

A composite score is given for an applicant based on parameters such as credentials, previous experiences, liklihood to succeed, personality, interest in the specialty..etc.

We rank applicants based on the composite score regardless of whether the applicants come back for a second look or not, or if they tell us how much they like us. It is usually irrelevant.

Still, a polite thank you note after the interview is still expected for courtesy.

Occasionally for those highly qualified applicants, we'll go out of our way to let them know that we're interested in them. But this doesn't happen a lot. Some programs do this all the time as a routine.

And we go from there...waiting for the results.

All in all, the NRMP is a joke. It should be like college or fellowship application process where you just apply to places where you think you want to be and hopefully you'll get interviewed and end up with multiple acceptances so that you can decide what is best for you.

Just my 0.02.

A lot of the medical subspecialties now use the Match also, and the number is increasing all the time. I think the Match is particularly bad in this situation, as there a lot more people married, with kids, already settled down who would really like to be able to just sign a contract vs. having to fly all over and spend a lot of money doing a bunch of interviews. For people like me (no spouse or dependents) the Match wasn't too bad, but it does lead to people having to do a LOT of interviews in things like GI, cards, hem/onc, and that is expensive and can be problematic from a scheduling standpoint, as residencies expect residents to be working and it's often hard to get off and/or cancel your resident clinic when you have all these interviews.

If the OP wants to express strong interest without telling multiple places they are his #1, could tell #2 and 3 you are "ranking them very highly and would love to go there". They'll probably know it means they aren't #1, but as the above post mentioned, they likely have already decided where to rank you. Still, I have no doubt that at least at some programs, if you are on the cusp of not matching vs. matching, the program's perceived desire of how much you want go there (vs. thinking you aren't super eager) can sometimes swing things one way or another.

 

[Ludicolo]

All in all, the NRMP is a joke. It should be like college or fellowship application process where you just apply to places where you think you want to be and hopefully you'll get interviewed and end up with multiple acceptances so that you can decide what is best for you.

And if you don’t get multiple acceptances? Or if you get an offer from the first place you interviewed (which may be your “safety” program), and they want you to decide in 48 hours, do you cancel every other program on your list? Do you decline this offer, gambling that you might not get another? This type of “rolling admission” favors those who interview at a given program early, does it not? In the spirit of competition, why wouldn’t programs just start interviewing applicants earlier, like July? Or during M3 year? Or after Step I results are back? Identify strong candidates early, before they even decide what specialty to pursue.

Without the match, people will be forced to make decisions before all options are known. The match, as imperfect a system as it is, eliminates a lot of the pressure off of both the applicant and the program.

Is there a stronger way to say "I'm ranking you very highly"?

How about, "I'm ranking you very, very highly"?
Couldn't resist.

 

[drbetty]

You tell them they're your #1 as well.

We rank applicants based on the composite score regardless of whether the applicants come back for a second look or not, or if they tell us how much they like us. It is usually irrelevant.

Other than obvious ethical reasons, since "it is usually irrelevant", I wouldn't lie.

 

[doozenberg]

What do people think about telling your number 2 and 3 programs explicitly that you'll definitely be ranking them within your top three?

A bit more specific and revealing than "very highly."

 

[error404]

What do people think about telling your number 2 and 3 programs explicitly that you'll definitely be ranking them within your top three?

A bit more specific and revealing than "very highly."

Yeah... except that they'll both just assume you're ranking them third.

Is there anyone out there who hasn't told their #1 that they're the #1? You know, in the spirit of the match?

 

[CaMD]

Yeah... except that they'll both just assume you're ranking them third.

Is there anyone out there who hasn't told their #1 that they're the #1? You know, in the spirit of the match?

I just told each of my top 3 that would I would be ranking them "very highly." (This is mostly because I'm not entirely ready to commit to a #1.)

 

[drln]

I didn't say to any program that they'd be my #1, for what it is worth.

On a somewhat related note, what if a program emails you that they want you to come there, but you weren't even going to rank them? do you respond to that email at all?

 

[dragonfly99]

what if a program emails you that they want you to come there, but you weren't even going to rank them? do you respond to that email at all?

Don't respond at all or send them a generic thank you. Not much to do there...

 

[soulofmpatel]

Drop out of medicine and go into politics, bastards!

 

[peerie]

How about saying 'you are at the top of my list?' It doesn't say you are number one, but it does say you are - well, at the top of my list.

 

[SocialistMD]

All in all, the NRMP is a joke. It should be like college or fellowship application process where you just apply to places where you think you want to be and hopefully you'll get interviewed and end up with multiple acceptances so that you can decide what is best for you.

If you did this, it would be just like medical school application all over again. You would end up with the "top" applicants sitting on 4-5 jobs until early May when they finally decided where they wanted to go (having already gone to each city and found a place to live in that time), leaving the "bottom" few to have to sit and wait for a spot to open until the last minute. It may be okay for medical school, as fewer people have families at that time, but when you are planning to buy a house or have to find a 4 bedroom place to rent, it can't be done overnight. Plus, you then have to worry about taking your life support courses and hospital orientation in that span of time as well. The match is a much better alternative.

 

[Law2Doc]

How about saying 'you are at the top of my list?' It doesn't say you are number one, but it does say you are - well, at the top of my list.

Saying "you are at the top of my list" pretty clearly implies #1. The top of any list is #1. "Among the top", "one of the top", "very high on your list" or other modifiers that suggest you are considering others is more honest.

Doesn't matter a whole lot at this late date -- most schools probably are winding up whatever ranking meetings they are going to have.

 

[drphysicianMD]

Saying "you are at the top of my list" pretty clearly implies #1. The top of any list is #1. "Among the top", "one of the top", "very high on your list" or other modifiers that suggest you are considering others is more honest.

How about saying 'you are at the top of my list?' It doesn't say you are number one, but it does say you are - well, at the top of my list.

I wrote to my top three and actually used "you are at the top of my list" because I am not sure exactly which will be #1, and two of the program directors responded that they were pleased to hear I would be ranking them "very highly".

The other one expressed enthusiasm for being my "first choice", because "I presume nothing is above the top of the list".

 

[peerie]

Interesting! this is all so subjective really. Like reading tea-leaves, as someone said. It's all what we read into these inscrutible comments.

I disagree that 'top' has to mean #1, there is wiggle room there. Saying number 1 = being number 1.

 

[Law2Doc]

Interesting! this is all so subjective really. Like reading tea-leaves, as someone said. It's all what we read into these inscrutible comments.

I disagree that 'top' has to mean #1, there is wiggle room there. Saying number 1 = being number 1.

As the prior posters post makes clear, at least some PDs will think the top is number one. So no wiggle room, the statement is simply misleading. I would adjust it so that you aren't causing a misunderstanding. Saying you are ranking something very highly is less cagey than the top.

 

[MedObsession]

I wrote to my top three and actually used "you are at the top of my list" because I am not sure exactly which will be #1, and two of the program directors responded that they were pleased to hear I would be ranking them "very highly".

The other one expressed enthusiasm for being my "first choice", because "I presume nothing is above the top of the list".

I definitely considered using the "at the top" of my list phrase, but ultimately decided against it because there really is only one spot at the top. If you go to the top floor of the building, it is the highest number, not a few floors below it. In the end, for my #1 I told them I would be ranking them "#1." For programs #2-4, I said I was ranking them "very highly." I don't feel that I mislead anyone and people responded without me feeling like they had misinterpreted the intention of the email.

 

[drbetty]

I definitely think the phrase is vague with various interpretations. It depends on the context, too, as "I was at the top of the mountain" seems more obvious to me than "this student is at the top of his/her class", a phrase I have heard used to describe one of many students at the top % of his/her class. It's all semantics.

 

[Law2Doc]

I definitely think the phrase is vague with various interpretations. It depends on the context, too, as "I was at the top of the mountain" seems more obvious to me than "this student is at the top of his/her class", a phrase I have heard used to describe one of many students at the top % of his/her class. It's all semantics.

Sure, but semantics matter. If your phrasing is such that the average PD thinks you are "saying" number 1, then you are being misleading, even if you didn't mean it that way or feel you left some room for interpretation. Best to use precise language that doesn't create the misunderstandings, and subsequent ill will. So saying someplace is the top of your list will mean to a LOT of people the absolute top. Telling a place you are ranking them highly, or among your top programs doesn't create this misunderstanding. And you won't get emails like the person above did from a PD thinking you ranked the program #1 when you didn't.

 

[civic4982]

1)mislead them ino thinking you're "saying" they're number one.
2)leave enough gray area in the word "top."
3)rank them how you feel is right for you and let them rank you how they feel is right for them.

In the end it all works out the same and students match to the right places. If we all did this then we would be able to take out that "interested" portion of their ridiculous ranking process which has no benefit to any of us and really only creates a culture of @$$-kissing in the interview and match process. They frankly shouldn't be judging you on these issues of how much you like them whether it's #1 or #2 anyways so make it a moot point by telling everyone they're in the "top."

 

[Law2Doc]

...

In the end it all works out the same and students match to the right places. If we all did this then we would be able to take out that "interested" portion of their ridiculous ranking process which has no benefit to any of us and really only creates a culture of @$$-kissing in the interview and match process. They frankly shouldn't be judging you on these issues of how much you like them whether it's #1 or #2 anyways so make it a moot point by telling everyone they're in the "top."

It's not about how it ends up/works out. It's about being ethical and not misleading folks. Better not to go down the path of imprecise language resulting in people feeling they got snubbed. There really is no need to do this.

 

[dragonfly99]

It's not about how it ends up/works out. It's about being ethical and not misleading folks. Better not to go down the path of imprecise language resulting in people feeling they got snubbed. There really is no need to do this.

I agree in principle, but the whole reason that applicants mislead programs is that a lot of programs will rank applicants by how "interested" they think the applicants are, rather than only by academic qualifications + how well they actually think the students/applicants will fit into their program. Some programs also pressure applicants into thinking they won't be ranked highly unless they rank that program #1. I think the candidates' unethical/misleading behavior mostly stems from the unethical behavior of the programs, and if they just stopped trying to game the match, there would be far fewer APPLICANTS trying to game the match as well.

 

[Law2Doc]

I agree in principle, but the whole reason that applicants mislead programs is that a lot of programs will rank applicants by how "interested" they think the applicants are, rather than only by academic qualifications + how well they actually think the students/applicants will fit into their program. Some programs also pressure applicants into thinking they won't be ranked highly unless they rank that program #1. I think the candidates' unethical/misleading behavior mostly stems from the unethical behavior of the programs, and if they just stopped trying to game the match, there would be far fewer APPLICANTS trying to game the match as well.

I don't disagree that programs put a premium on folks who indicate their interest. I'm just saying you can indicate "interest" without misleading a program by words that suggest they are #1. Being unethical isn't any better behavior if you are doing it for a reason. There really is no defense -- there is no "I was unethical because the programs reward that kind of behavior". Lots of unethical behavior gets rewarded. Doesn't make it right, and that goes doubly so when you embarking into a profession.

Besides, if applicants as a group behaved ethically, only told programs they were #1 if that was the case, and otherwise made clear that the program was among their top choices, I doubt the programs' rank lists would change one iota. So it's kind of a cop out to put the blame on the programs for soliciting this kind of behavior. They want a statement of interest, not necessarily language stating where you are ranking them. Applicants, in their own paranoia are taking it a step further and assuming that programs need to be stroked into thinking they are the number 1 choice. But I think this is an assumption bereft of actual evidence that it makes a difference. So be ethical and honest in the process. Express interest without lying or misleading. It will ruffle fewer feathers and everything will likely work out the same in the end.

 

[jrs1234]

I don't disagree that programs put a premium on folks who indicate their interest. I'm just saying you can indicate "interest" without misleading a program by words that suggest they are #1. Being unethical isn't any better behavior if you are doing it for a reason. There really is no defense -- there is no "I was unethical because the programs reward that kind of behavior". Lots of unethical behavior gets rewarded. Doesn't make it right, and that goes doubly so when you embarking into a profession.

Besides, if applicants as a group behaved ethically, only told programs they were #1 if that was the case, and otherwise made clear that the program was among their top choices, I doubt the programs' rank lists would change one iota. So it's kind of a cop out to put the blame on the programs for soliciting this kind of behavior. They want a statement of interest, not necessarily language stating where you are ranking them. Applicants, in their own paranoia are taking it a step further and assuming that programs need to be stroked into thinking they are the number 1 choice. But I think this is an assumption bereft of actual evidence that it makes a difference. So be ethical and honest in the process. Express interest without lying or misleading. It will ruffle fewer feathers and everything will likely work out the same in the end.

I only sent out one #1 letter to my #1 program, but I feel I have to play advocate for fellow applicants.
Yes there are programs that want a letter of intent, then there are the programs that act in violation of the match by saying if you do not write a letter stating your ranking them #1 that they won't even rank you. I don't understand that logic at all, but it did happen to me more than once. Shouldn't applicants spending hundreds of dollars and missing vacation time or learning experiences we are paying for be enough for programs that you are going to be interested in going there. Even still if you aren't interested wouldn't you just not rank them?

I agree two wrongs don't make a right, but there is no winning with some programs. They want to know your position, but won't release theirs and they hold ALL of the cards. That being said, I did not send out a note to any of those programs that they are my top or number 1, but attended multiple interviews. I did write I note that I could see myself fitting in in those locations. However, I can only assume I will not be ranked at those programs as they were very direct in their intentions - that they wanted to know I wanted to be there above any other location - which is unfortunate.

I totally understand why an applicant that only attends three-four interviews would feel pressured to send out a note saying multiple locations are their number one or top choices.

 

[drphysicianMD]

I wrote to my top three and actually used "you are at the top of my list" because I am not sure exactly which will be #1, and two of the program directors responded that they were pleased to hear I would be ranking them "very highly".

The other one expressed enthusiasm for being my "first choice", because "I presume nothing is above the top of the list".

I honestly did not expect this interpretation after talking to many friends that program directors only care if you literally spell out "number one" and I felt like the program director was putting words in my mouth (but apparently several of you believe otherwise). Also, because the other program directors interpreted it the way I had intended, I was surprised.

I should have mentioned that this particular program director also highly encouraged/recommended a second look in his response. Because I felt uncomfortable with his interpretation, I clarified to the program that I would be ranking them "very highly" because I am not sure exactly, and apologized for not being able to make another visit.

Needless to say, I have yet to hear back from the program (it's been a month and this program director usually responds immediately by phone or email), and I probably dropped a few spots on their list for my honesty...

 

[peerie]

To be honest, I find this all very upsetting. The program I like best I have never had to disemble or BS or say anything or do anything but just be my best. They are an excellent program and have never been anything but supportive and polite. I have always felt at home there and like I could really thrive.

Other programs have done this: sent me emails basically demanding to know where I am placing them, sent me numerous emails, cards and letter and then not responded to me when I politely expressed interest and told them I was very interested in them.

Plus, every permutation in between. I thnk it is all BS to be honest. I don't like being forced into a corner, nor do I like being ignored (after having been wooed). This is a very distressing process and I find it upsetting to pulled back and forth and to realize that this is a serious committment for the next three years - and am I making the best choices or doing the right things? If do not respond 'correctly,' does that move me down someone's list? what is the 'correct' response? Ack! this is stressful stuff.

I don't mean to be dishonest or unprofessional or whatever, but it is really hard to know what to do or say sometimes. And the stakes can be high.

 

[Law2Doc]

To be honest, I find this all very upsetting. The program I like best I have never had to disemble or BS or say anything or do anything but just be my best. They are an excellent program and have never been anything but supportive and polite. I have always felt at home there and like I could really thrive.

Other programs have done this: sent me emails basically demanding to know where I am placing them, sent me numerous emails, cards and letter and then not responded to me when I politely expressed interest and told them I was very interested in them.

Plus, every permutation in between. I thnk it is all BS to be honest. I don't like being forced into a corner, nor do I like being ignored (after having been wooed). This is a very distressing process and I find it upsetting to pulled back and forth and to realize that this is a serious committment for the next three years - and am I making the best choices or doing the right things? If do not respond 'correctly,' does that move me down someone's list? what is the 'correct' response? Ack! this is stressful stuff.

I don't mean to be dishonest or unprofessional or whatever, but it is really hard to know what to do or say sometimes. And the stakes can be high.

If programs did what is bold above, you ought to report them to the NRMP. Programs in the allo match cannot demand to know where you are ranking them or cornering you or otherwise negotiating how you will rank them. If you don't report them, nobody ever knows and this behavior continues.

All I'm saying is that, as evidenced in the prior poster's PD responses, people can take the phrase I'm putting you at "the top" of my list as saying I'm ranking you #1. So I probably wouldn't use that phrasing. If you've already sent such a letter, I probably wouldn't do anything, because it doesn't help your cause to send a clarifying letter. But for folks in future years, I would suggest that this is a misleading phrasing.

 

[doctah27]

I was exactly in that same situation .I thought I wouldn't really match at my #1, highly competitve..20 applicants interviewed per interview day for couple spots. Had good feedback during interview but nothing extraordinary.

my #2 after my interview told me they'd rank me really high so I'd ensure a match.

I told my #1, they're my #1 thru snail mail and few mo later, email. I told #2 they are at the top of my list and I'd be happy to work w/ them.