What will matter most to you when you create your ranklist?

Discussion in 'ERAS, SOAP, and NRMP Match' started by Cholinergic, Dec 27, 2008.

  1. Cholinergic

    Cholinergic Member
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    What are your most important variable? Location? Program size? The Chair/PD? The residents? Academic status (ie for future fellowship)? Least stressful appearing program? Or are you just ranking based on how you felt during the interview?

    For me, in my spreadsheet the location and call schedule carry the most weight.
     
  2. blabbyblab

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    I weighed heavily some of the intangibles: how sharp the residents appeared, how good were the morning/afternoon reports, whether or not I would fit in. I can't even remember the call schedule at my #1.
     
  3. John Deere Gree

    John Deere Gree my tractor IS sexy!!!
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  4. Miami_med

    Miami_med Moving Far Away
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    Instinct was HUGE for me as well. I also wanted to be in a scenario where I wouldn't be financially stressed, so pay and benefits mattered. Prestige mattered little, but the overall appearance of the quality of graduating residents mattered a LOT.
     
  5. Ashers

    Ashers Bacteria? Don't exist.
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    The number of hot, single guys. :D j/k

    As of right now, it's how I felt during the interview day.
     
  6. waldenwoods

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    I'm going with my gut. I have found that I'm paying attention to how favorably the residents talk about the curriculum/their educational experiences, and about the support they get from the faculty and the program leadership. Before I started interviewing, I never would have thought that things like how well the residents get along with faculty would be an important factor.

    The more tangible stuff doesn't factor in as much. Call schedule doesn't matter to me--I've interviewed and thought about how nice some of the call schedules were when they were presented to me, but I've forgotten the programs with the nice call schedules. I have ruled out a program because I realized I didn't want to live in a particular city, but I am not looking more favorably upon programs because of their geographic location. When I am actively thinking about whether I like a particular program, I end up weighing the # of elective blocks available during the course of the residency and how many weeks of vacation per year. However, none of these quantifiable aspects of the programs are as important as the overall impressions I have of the programs.
     
  7. peerie

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    The top three programs I like best are the ones where I felt excited and interested in the residents and the teaching. Also, location is key for two of them but I know the history of both programs and they send really well trained people to all kinds of great places. Rigorous training and excellent placements.

    All three programs were really good to me and I felt really welcome and encouraged by the faculty and PDs. I felt like I could be myself and for the most part relax. I guess you could say this is an instinct or 'gut' feeling. I also guess, that true interest is hard to feign and maybe they picked that up. So far my top three places have been very positive towards me. Wow!
     
  8. Samoa

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    The following are all pretty equally weighted, although #4 is a tiebreaker if the first three aren't significantly different.

    1. Case distribution and volume
    2. Attitude toward resident teaching/operative autonomy
    3. Breadth and quality of research opportunities.
    4. Faculty/resident interaction, my own impressions of them as individuals and as a group. Do I fit in with the group already there, or would it be an effort to get along with them? Are there any I already don't like?

    In a situation where the sum of the above factors is roughly equal, the following become important:

    1. City size & recreational activities available
    2. Stipend/cost of living
    3. Unique "extras" touted by the program
     
  9. yumita

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    Since I had only applied to programs that already fit certain of my preferences (underserved, spanish-speaking communities), the following have become my criteria, mostly in order of importance:

    1) Happy, smart, interesting and easy-going residents.

    2) Happy smart, interesting and easy-going faculty that seem truly to like teaching.

    3) A common dedication to service.

    4) Geography and cost-of-living.
     
  10. theKirk

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    I LOVE BEING A NON-TRADITIONAL STUDENT WITH A FORMER CAREER!

    Interview season is TOTALLY different for us:


    1) Safety of Living Situation (wife will be home with two kids)
    2) Good school systems in area for kids
    3) Quality Daycare.
    4) Once these are satisfied, whomever has the best training with these criteria met.

    5) oh, and as few douchebags in the program as possible.....
     
  11. Samoa

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    Speak for yourself. Not every non-traditional student with a former career has the same priorities as you.
     
  12. peerie

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    Hey, that sounds just like me! oh, wait except that I am the wife and hey! it's my male husband who will be home with - hey, we don't have any kids yet. Do dogs count?

    I am non-traditional and older, too. Just like you. :)
     
  13. DonStracci

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    Agreed, it is quite different! I have to factor in spouse's employment opportunities and willingness to relocate to areas, and housing market in the areas I've interviewed. My husband is very involved in this process- his input is very important.
     
  14. Samoa

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    That's nice for all of you. But again, not every non-traditional student is married with kids. Or considers marriage and children a priority higher than residency training. And conversely, I'm sure there are plenty of traditional students who do have these as priorities.

    What I really don't want to see is people getting stereotyped because of their demographic.
     
  15. Miami_med

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    I have a wife and kids, but I largely ruled out places to interview in which I couldn't make it work with them. With the exception of one program at which I misunderstood some of the benefits package, this was largely a line in the sand more than a ranking criteria per se. Of course, falling behind the line was a big problem. My wife and I agreed that I have spent WAY too many years in training and spent WAY too much money to get sub par training at the most critical level.

    I'm not a prestige hound, and name recognition ranked somewhere close to proximity to the moon for me. However, training quality was huge and there was some weak correlation between those two at times. I had geographic restrictions up front, and geography did matter some, but those restrictions created less impact for it in my rank list. As I said before though, I really was looking for a feeling that the program graduated really competent people. I think things like operative autonomy, case volumes, hospital variety, etc... factored much more into that perceived competence than being independent variables.
     
  16. John Deere Gree

    John Deere Gree my tractor IS sexy!!!
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    WOAH!!!

    The "Us" Kirk is referring to is probably his family NOT non-traditional students in general as I think you are perceiving.
     
  17. theKirk

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    ^^^precisely john deere! Thanks.

    Sorry for the mix up Samoa. You got really hot on that one fast.
    Take it easy.


    BTW, you and Tag-a-Longs are the caloric bane of my existence.


    EDIt: and to clarify a little, I wholly agree with DonStracci, my spouses input is huge. We are about to enter one of the most difficult times in training, and it would be worse 10 fold if you come home with what little time you have and everyone at home is miserable.
    Basically, we had planned to have a few criteria each program had to meet (safe neighborhoods not ridiculously far, good school system options for kids) and THEN made a rank list of those programs.
    I wish I could say that I would blindly gun for the most prestigious program, with no consideration of anything else, but whats the point of top training, when my wife is getting mugged or worse and my son is coming home saying "2+2 = giraffe"

    Just saying things are different for me and my family going through interview season than the majority of my peers. Very interesting how your life situations totally change perspective, is all I'm saying.
     
    #17 theKirk, Dec 29, 2008
    Last edited: Dec 29, 2008
  18. sandraf

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    I'm in a very peculiar situation, as well. Geography is everything for me. Three kids and a husband with a great career, it is either the city I already live in, or pack the bags and go back to my country. I am very lucky there's a wonderful residency program here, where I can see myself happy, and that for sure will make me a well-rounded clinician again. But I gave up cardiology, already. I am not going to train for 7 years and miss my kids' childhood.
    So, if in one hand, it is very limiting and statistics don't favor me at all, on the other hand, keeps it extremely simple for me (us). ;)
     
  19. bigDinLV

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    I'm looking for a good program that is close to home. Luckily for me, home is fairly close to Chicago.
     
  20. masterofmonkeys

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    Gut feel mostly.

    But also:
    1. How much politics were brought up in an 'everyone who's intelligent agrees with me!' way. Any program where it happened more than once. Not ranking high. Especially if a PD or faculty member engaged in proselytizing.
    2. How motivated the residents were. i know the 'leaders in the field' thing is overused, but I really am looking for a place where the people are smart, and motivated, and want to be some of the best. Even if that means going private practice and being one of the best private practice docs out there.
    3. Research mentorship. Not just availability of pipette-monkey slots, but preparing the residents for a career as PIs with their own interests and future fields of study.

    Just some things offhand I looked at.
     
  21. zoondel

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    I've had a hard time with this one.
    I'm a logical thinker and I often make the mistake of using objective criteria to exclusion of all others - throughout the interview process, I've learned, by default, that such a method won't work here.

    1. Geography, +/-commute, since I'm staying in an urban area.
    2. Gut - this is the least objective, but I definitely have had "impressions." Which is why I also think it's important to go back for second looks.

    3. Resident happiness and fellowship prospects - these are tied, and tricky to reconcile if they don't match up.

    4. Education - this means more than just training, because you can get good clinical experience without a good curriculum.

    Currently, I've got my top three narrowed down:
    -one has a big name but rumors of slavery,
    -one has a good name and fellowship prospects but I got the impression that many residents were unhappy
    -one has a good name (3rd of 3), decent fellowship prospects, but the residents are pretty happy, the PD is awesome, and the schedule is great.

    I definitely need some second looks.


    On the other hand, I would still have to keep in mind that residency is "only" a small portion of my future career, right?:cool:
     
  22. Law2Doc

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    A lot depends on how long the residency path is. Anyone can grin and bear it in a bad residency for a prelim year, I would think. But if we are talking 3-7 years then I think you are insane if you use the above statement as your mantra and go someplace where the residents are "unhappy" or references to "slavery" abound. A 3 year stint can likely feel like 30 if you dread every minute of it. One where you the positives outweigh the negatives probably flies by fairly rapidly. So I probably might promote resident happiness above some of the other factors you may be considering, given your end result.
     
  23. Samoa

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    Let's just say that for a woman in a heavily male-dominated field, particularly a woman who is over 32-33 at the start of residency, it's very easy for the people making decisions to assume that you'll be OK with sub-par training if it allows you to be near your significant other, get married and have children. Whereas with a man the assumption regardless of age tends to be that you want the best training you can get, and will take your family with you wherever you match.

    It's a difficult issue to overcome in people's minds. Particularly when the men making most of the ranking decisions grew up in an era when women almost never had careers of their own, and have always made enough money that their own wives never had to make the tough decisions that come with a real career, either. So I'm actually happy when I get asked about it directly, "illegal" as that question technically is, because it allows me to articulate my priorities clearly. But a lot of people still assume without asking.
     
  24. LadyGrey

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    Samoa: I hear ya about obnoxious assumptions people make. And I really admire your dedication to quality training above all else.

    I know that for me, my ROL will depend on what programs will make me a great doctor (without making me entirely miserable). However, initial choice of where to apply did take into account my partner's job. He has made some career decisions in the past, including pretty early in our relationship, to stay within reasonable distance of me, so we're committed to balancing these things as much as possible. I am lucky that his job is somewhere that there are also good training opportunities. If they all sucked, well, then the calculations would be different and I'd likely be resigned to an LDR for a while.

    So yeah, assumptions are bad, because every applicant, and every couple/family, and every situation, is different.
     
  25. sandraf

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    I agree. Although I fit in the stereotyped group for most of it, people need to have an open mind and check about a particular person's plans and priorities. I know some people question the sincerety of our answers when they think they have us all figured out already... :(
     
  26. Old_Mil

    Old_Mil Senior Member
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    Vibe + People. Nothing in this world is sufficient compensation for a bad workplace.
     
  27. zoondel

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    Let's just say that for a man with a family in a heavily female-dominated field (peds) the perception I've gotten is that many people think that time with the wife and kids matters less to a man because it's the training that matters most. Meanwhile, my wife has a successful career as a lawyer, and she'll be paying the bills for quite some time.
     
  28. Samoa

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    Your point? It's not clear to me what you're trying to say here.
     
  29. zoondel

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    Sorry, got cut off there.

    With my wife in a stable, relatively non-mobile job, a house, living close to family, I'm willing to limit my options in the face of those assumptions. I was just pointing out the situation converse to your own.

    It's not fun being pigeon-holed.
     
  30. Samoa

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    True, but that's a voluntary limit that you set yourself. Other people's beliefs about your priorities don't artificially decrease the number or lower the quality of the options among which you get to choose.

    That's my point--not that it's wrong to make such a choice. But it is wrong for others to make it for you.
     
  31. sandraf

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    That's my point--not that it's wrong to make such a choice. But it is wrong for others to make it for you.[/quote]

    :thumbup:
     
  32. zoondel

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    Agreed.
     
  33. dragonfly99

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    Agree w/samoa r.e. the assumptions made about women during some residency and fellowship interviews. I did not encounter this while interviewing for medicine residency, but I certainly did during cardiology fellowship interviews. I think this came about because
    a) I'm 3 years older
    b) I'm female
    and
    c) cardiology is a mostly-male field and a lot of the decision makers are over-55 cardiologists who have always had a stay at home wife and some can't fathom that a woman age 30 might be placing her career as very very high priority at this point in her life.

    The fellows and almost all the younger faculty, and some of the older ones, were still very cool, however.
     
  34. DarthNeurology

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    I think it is really hard to know which program will allow you to achieve the "best training". In the end how hard you work determines what type of physician you will become. For some fields it is hard to know what is best outside of a university program, even some community programs offer excellent training.

    When I interviewed fellow applicants were asking questions about the call schedule, variety of patients, local atmosphere, etc . . . It is hard to ask point blank "Do you provide excellent clinical training?" as all program directors feel that their program does. I think finding a place that offers you the best training environment can be very different for different people.

    If you like more a friendly/laid back atmosphere where you feel freer to ask questions and take great autonomy then more power to you. Some high powered "prestigious" programs are very regimented in terms of what residents can and can't do. If I am running the show by the end of my residency regardless of the brand name appeal of the place then I feel I have gotten good training.

    However, maybe surgical specialties are more heterogeneous in training quality.
     
  35. soulofmpatel

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    I am most interested in being happy while training. Thus, the most important factors are location, a reasonable schedule, and non-malignancy. Location is the most important single factor by a large margin
     
  36. ranmyaku

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    I feel exactly as you do.
     
  37. UpperEastSideOB

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    Same here. My top 3 are very similar so I think location will also play a huge role.
     
  38. Samoa

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    They can be. There are a lot of programs that either aren't stable enough to reliably provide a full spectrum of cases, or simply don't have someone on staff in certain subspecialties and aren't even looking. Or maybe the person they have is doing double duty in several subspecialties, or isn't known well enough to get referrals, or wasn't particularly well-trained in that area. There don't seem to be those kinds of problems on the medical side of things.

    Not that I'm complaining--you're absolutely right that a large part of how you turn out is due to your own effort. And I certainly wouldn't trade even the worst training in my field for the very best training in IM or peds. But in a skill-based field it's much harder to learn the skills you want if there's no one around to show you how to do things.
     
  39. docjolly

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    i'm still trying to figure a lot of this out, but here are some (not all) of the important factors for me:

    1. location-->I'm a huge fan of living in a big city!

    2. my initial impression during the actual interview...this is key for me. Irrespective of up-to-date websites and the pre-interview dinners, i can be certain of how I will rank a program, simply based on my interaction with the PD and the other faculty members. I consider the residents, but i don't give my initial impresion of them too much weight. This is especially true of the senior residents, who, btw, will be gone by the time i arrive in July.

    3. Support: Are my family members/close friends nearby? I know, for certain, that I don't want to move where I have neither. Residency is very stressful, and to be honest, I would love to spend most of my free time with my non-medical friends.

    4. Will I fit in? Do I feel comfortable around the residents? As a side note, since I don't drink alcohol, it's impt. to know that there are social events going on w/the residents other than hitting up the local bar after a shift..
     
  40. LadyGrey

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    I do drink alcohol, but I'm still turned off by programs where all the residents seem to talk about among themselves is "oh man, I was so wasted last night, that was so awesome, let's do that again." I'm all for going out and having a few drinks, but jeez. I think I got a lot of that out of my system in college while these residents were being the good premed kids who kicked my ass academically. ;)
     
  41. drbetty

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    Most important factors in making my ROL:

    1. gut feeling - residents + PD
    2. success of alumni with job or fellowship placement
    3. opportunities in international health & advocacy
    +/- geography
     
  42. yadayadadude

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    I'm curious to hear how this has played out for you. Have you had some kind of negative experience(s) that support this view? Do you think there were programs that chose not to interview you (or rank you) based on outright sexism (as in, "She'll never come here; it's too far to move and she probably has a SO in her current location")?

    FWIW, I met plenty of married men on the interview trail who were clearly considering their SO's (professional and otherwise) welfare in choosing programs. For example, one man I met (married to a food writer) mentioned that San Francisco programs were at the top of his list because San Francisco is the second best food city in the country. Another one was very keen to return to California from the East Coast because his wife's family is here. I met a lot of guys like that. Also, despite the fact that I am exactly the woman you say programs view with suspiscion (wearing a wedding ring; pregnancy mentioned in one of my LORs so no secrets there; spouse has a niche-type career that's not terribly portable), I didn't get the impression in any way that programs expected me to (choose to) accept sub-par training in order to accomodate my man. I suppose there could be some kind of hidden old-boy's-club type discrimination going on, and I guess I won't know until I see where I match, but I really don't think so.

    I'm less arguing with you and more just very curious about why you feel the way you do. Maybe I'm kidding myself about sexism in medicine, but I just don't believe I've personally encountered any.
     
  43. Samoa

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    You're missing my point. It's the *applicant* considering their SO's welfare, not a presumption on the part of anyone else.

    And in response to the rest of your post, it's certainly possible. I don't expect I'll ever know for sure.
     
    #43 Samoa, Jan 25, 2009
    Last edited: Jan 25, 2009
  44. yadayadadude

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    I see. Well, if it's people making choices according to their own priorities, and not the presumption of anyone else, I don't see why you care so much. It doesn't affect you.
     
  45. LadyGrey

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    I think you're still missing the point. In the cases that you mentioned, you're right, it's people making choices according to their own priorities. Nobody else is affected, nobody minds, etc.

    What Samoa is concerned about is the possibility that programs are making assumptions based on gender.
     
  46. PeepshowJohnny

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    Oddly enough, it turns out philosophy of the program has really shot up there for me.

    I've interviewed at some really fine institutions. A lot of things like training, location, prestige, research...they're all top notch so it's a push.

    However, a few places have had either the PD or the chair or somebody say something during the day or during the interview that struck me as "this is a place I would fit in" and that's been a HUGE factor.
     
  47. zoondel

    zoondel SDN Lifetime Donor
    Lifetime Donor Classifieds Approved 7+ Year Member

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    I agree with this 100%. In the beginning, technical factors about the program drew my attention, like "we offer the option to spend time in specialty clinics" and mutli-disciplinary case conferences, and prestige, research, etc.

    But there's a difference between the residents saying "oh yeah, the program is great about addressing our concerns" and the PD himself/herself saying, "you will work hard, but we are always concerned that our residents are happy with the program, the schedule, the education," etc.
     
  48. yadayadadude

    7+ Year Member

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    No, I completely understand that. It was very clear in her posts and I can read. In my post, I said:

    Have you had some kind of negative experience(s) that support this view? Do you think there were programs that chose not to interview you (or rank you) based on outright sexism (as in, "She'll never come here; it's too far to move and she probably has a SO in her current location")?

    I cited those examples of men considering the needs of their partners because I think this sort of thing happens equally among male and female candidates and I think PDs understand that. I disagree with her position that programs are making asymmetrical assumptions about female candidates, but I am willing to be wrong here and so I was interested to know if she has had experiences to support her opinion.
     
    #48 yadayadadude, Jan 25, 2009
    Last edited: Jan 25, 2009
  49. waldenwoods

    7+ Year Member

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    I agree 100%, too, about the program's philosophy being important.

    There's a difference between saying that there are protected didactics and sitting in on morning report where each resident walks in the door and deposits his/her pager in a basket for the chief resident to hold onto *and* when a pager beeps, watching the chief call the page back.
     
  50. Samoa

    Physician Pharmacist 10+ Year Member

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    Yadayada, your question's been answered, to the extent that I'm willing to do so. Particularly since I sense that what you really want is to argue with me about whether my perception of the situation is accurate. And I'm not interested in having that discussion with a random stranger.
     

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