Whats the new "Magic Number"?

[CueDoc]

The magic number was 10, or so we thought. I know several people, on this board and in the real world, who ranked more than 10 programs (not couples matching) and did not match into EM. I also know of several people who were competitive candidates who matched at their 11/12/13 spots. What are your thoughts?

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[Haemr Head]

With every program seeing a +15% increase in applications and only 6 unfilled spots in the country, this has been the most competitive year in the history of the specialty. Perhaps we have peaked, since crowding may make this field less attractive as time goes by. However, it does not appear to be letting up. The highly competitive crowd will usually match at their top 1-3 choices (at least if they behave themselves at the interview and don't pick a fight with the janitor). But it now seems that average applicants may need deeper match lists to avoid the scramble. I wish someone could invent a better system. I admit I am unsure at present of what advice to give in terms of how many places to interview. Matching at your 11th spot just isn't how it is suppose to work.

When I see what is happening, I'm sure glad I got into this early on. A common reflection among senior faculty is that we could not get an interview at our own programs today.

 

[BadVB750]

Well, I'm about as average (maybe even a little below) as you can get with stats and I matched at my number #3. I was very realistic with my chances and competitiveness and applied to a lot of programs (50, about 25 of those were programs I thought I had no chances, but a boy can dream). I feel very lucky to match. I did well on most of my interviews and that is what I attribute most of my match success too. I guess my point is there is no magic number or magic stats.

 

[Apollyon]

I guess my point is there is no magic number or magic stats.

Lies, damn lies, and statistics. I see your point, but you're wrong. The "magic number" referred to does exist and is (historically, adjusted year to year) how many programs a person must rank for a 100% match rate. For years past, it was 7.5, so, statistically, if one ranked 8 programs, 100% of people matched. The "suicide matchers" or the dopes that only ranked 3 or 5 programs (despite being selected for interview, or interviewing, at many more programs) that don't match aren't included.

 

[BadVB750]

(historically, adjusted year to year)

If that is the case it is pointless to think about since you won't know till after the fact.

 

[Dr. Caveman]

I don't think there is a magic number....Getting the grades, board scores and slors just buy you a lottery ticket.... after that unless you're connected its random and you just hope your ticket comes up.

I played by all the rules: good grades, 230+Step1, 250+ step 2, rotated at my number one got great evals and didn't match there so all I can say is there is no guarantee....applied to 24 interviewed at 6 and matched (way below the magic number). I am happy where I matched and I really like the program but I still feel that there is a lot of randomness to the process, it wasn't my number one and I had good stats. In addition, I know people that matched at top name programs with "lower" academic stats while people with higher had to scramble or went down their list(and no the scrambling people weren't jerks )...

So I think the answer is do all that you can to buy a ticket for the lottery and then stay out to the results...you match where you're supposed to be or not... taking that approach just makes your life alot simplier you then can deal with the situation when it arises...there is no way to rig the match, no guarantees and trust no programs just kindly smile, say thank you and privately pray to the match gods And best of luck to all

 

[Freestyle22]

I would like second this post. I had strong stats, excellent board scores, and excellent grades. I slid further than I thought was possible, but I was still pretty happy with my match. I would advice anyone applying not to be complacent with their numbers, but to apply broadly. I am convinced that I did not interview "poorly" either, as the programs talked highly of my application, and I had pleasant conversations with all. Do not trust the PDs that tell you how wonderful you are, regardless of the institution. Tell ALL the programs that you are interested in how much you would like to match at their program. If you are honest and tell your top 1-2, you love them and would be stoked to be there, and leave the others out, you make get burned by some schmuck that tells a chairman or pd that they would die to be at that program which may have still been in your upper tier. I've known several applicants that have had this situation happen to them and felt like crap about it, and their effort they put in during medical school. It can be a truly random process. The NRMP ultimately screws you out of the chance to have all your acceptances on the table for the first time in your life, and so you have to play the computer match game, unfortunate, but true. I would seriously give this advice to someone that had an excellent application, or an average one.

I don't think there is a magic number....Getting the grades, board scores and slors just buy you a lottery ticket.... after that unless you're connected its random and you just hope your ticket comes up.

I played by all the rules: good grades, 230+Step1, 250+ step 2, rotated at my number one got great evals and didn't match there so all I can say is there is no guarantee....applied to 24 interviewed at 6 and matched (way below the magic number). I am happy where I matched and I really like the program but I still feel that there is a lot of randomness to the process, it wasn't my number one and I had good stats. In addition, I know people that matched at top name programs with "lower" academic stats while people with higher had to scramble or went down their list(and no the scrambling people weren't jerks )...

So I think the answer is do all that you can to buy a ticket for the lottery and then stay out to the results...you match where you're supposed to be or not... taking that approach just makes your life alot simplier you then can deal with the situation when it arises...there is no way to rig the match, no guarantees and trust no programs just kindly smile, say thank you and privately pray to the match gods And best of luck to all

 

[trkd]

I don't think there is a magic number....Getting the grades, board scores and slors just buy you a lottery ticket.... after that unless you're connected its random and you just hope your ticket comes up.

I played by all the rules: good grades, 230+Step1, 250+ step 2, rotated at my number one got great evals and didn't match there so all I can say is there is no guarantee....applied to 24 interviewed at 6 and matched (way below the magic number). I am happy where I matched and I really like the program but I still feel that there is a lot of randomness to the process, it wasn't my number one and I had good stats. In addition, I know people that matched at top name programs with "lower" academic stats while people with higher had to scramble or went down their list(and no the scrambling people weren't jerks )...

So I think the answer is do all that you can to buy a ticket for the lottery and then stay out to the results...you match where you're supposed to be or not... taking that approach just makes your life alot simplier you then can deal with the situation when it arises...there is no way to rig the match, no guarantees and trust no programs just kindly smile, say thank you and privately pray to the match gods And best of luck to all

Actually, Apollyon is actually correct. There IS a statistical magic number. That is where the "8" comes from. I had faith in the match process before and I still do believe in it. BadVB750's situation seems nearly identical to mine. No, I didn't match at #1 but the match doesn't mean that you are guaranteed this. My #1 was super competitive. There were people much more competitive than me applying so they got the spot. I (extremely happily) got my #3. They liked me, I liked them. The match worked perfectly in this case. It doesn't for everyone but if you look at the algorithym for the match, it should be pretty close. I understand that it sucks for the people that had to scramble or got really low on their list but that doesn't make a system bad. It means that the places that the applicant wanted, didn't want the applicant as much as the applicant wanted them. This is the whole thing about finding a program where you "fit". Both people have to agree. A good applicant may run into problems if their top listed programs aren't as enthused about them as the the program at the bottom of the list. This doesn't mean the applicant sucks, the applicant and programs just didn't agree on a perfect "fit". How is this a fault of the system? How is this a matter of luck? I think about 15-20,000 people (at least!) of the 27,000 active applicants per year would agree that the match works pretty well. I have yet to hear of a better system.

Now, this issue is complicated by the couples match and the same issues are a bit trickier. THIS is where some unfortunate things happen. Unfortunately, this is also not a fault of the system. It is that you are trying to find PDs of 2 different departments thinking their respective candidate is a good fit, as much as the candidate thinks so. 553 couples of the 621 couples both matched and another 36 had one match. Only 32 couples had neither match. Many couples chose to only rank programs where they both must match. If they hadn't, it is likely that they would have matched, but separately. Even the vast majority of couples would probably agree that the match works well.

I am not unsympathetic to the scramblers. I just think the match is pretty good overall. It is kind of like the electoral system. If it was perfect, Bush would have never become president after losing the popular vote. But there is a reason for why it is the way it is.

(She steps down of the soapbox)

 

[Apollyon]

I don't think there is a magic number....

I would like second this post.

Lies, damned lies, and statistics. The number of programs to rank to ensure 100% match. That is the "magic number", irrespective of what anyone thinks.

Only on SDN will people argue fact with anecdote. If the number changes this year, we'll see.

 

[Freestyle22]

My point is that there is good potential to slide if your top programs are very competitive, even if you are very competitive. Don't forget about convincing the others that you would be a good fit for their program, by doing second looks, or sending interest communications or whatever. You may find yourself sliding farther down than you would like. Believing a PD at a competitive program, or your own that you wont go past them, can put you in a VERY bad position. As for the couples match, it is obviously a dangerous route to go in a competitive specialty. I know the couples on this board took a big hit this year. It's unfortunate for them, because they are doing it for the right reason and getting burned. It may be necessary to unlink eventually as you go down the rank list and just try to get in the same region if you have too. Yeah, the match isnt perfect, but if it bites you, its 100% rough for you, regardless of everyone else. I didn't scramble,and I'm happy, but I feel really bad for those people in the couples match.

 

[trkd]

My point is that there is good potential to slide if your top programs are very competitive, even if you are very competitive.

Being "competitive" doesn't mean an applicant deserves their top spots. Personality is huge. I realized this when a super "competitive" and also extremely knowledgable person I rotated with went unmatched. The thing is, he was super cocky and thought he was the $hit. Being "competitive" doesn't come with any guarantee. The "fit" is a huge concept discussed regularly on this board. It DOES have a big impact on where you match. This is not to say that the scramblers had bad personalities, they just didn't happen to choose programs that liked them most.

Don't forget about convincing the others that you would be a good fit for their program, by doing second looks, or sending interest communications or whatever. You may find yourself sliding farther down than you would like. Believing a PD at a competitive program, or your own that you wont go past them, can put you in a VERY bad position.

They are only doing what we do, trying to convince the other party that this is the place/person for them. It is trying to guarantee a high spot for both sides. It's dating of sorts.

Do not trust the PDs that tell you how wonderful you are, regardless of the institution. Tell ALL the programs that you are interested in how much you would like to match at their program. If you are honest and tell your top 1-2, you love them and would be stoked to be there, and leave the others out, you make get burned by some schmuck that tells a chairman or pd that they would die to be at that program which may have still been in your upper tier.

It would be silly to believe such guarantees. You go out there and act all smiley regardless of where you think you are guaranteed a spot. This is just being smart.

Sorry Freestyle. Definitely not a personal attack. I just disagree with your points which are shared by many. I just think that anger towards the match process is due to emotion as opposed to logic often times. I could be very upset/angry at the situation if it turned out poorly too, I just don't think it is the process' fault.

As for "having you offers on the table" and conducting a match in that fashion... it would never be feasible, not to mention it would draw this process out for months and months.

 

[SolidGold]

The real magic number is 136. That is if you were magically able to interview at all of them!

But even then, you might not be able to match!

Arguing a magic number is pointless. I know that 10 was the number you wanted to rank in order to match with 98% success, but that has changed this year. Obviously you need to know how competitive you are against the average EM applicant. Maybe we need to define what an average EM applicant is?

 

[Freestyle22]

I appreciate your sorry flaming post trying to rub salt in peoples wounds. Don't even try to insinuate that I didn't get my top choice(s) because of personality conflicts or fit issues. People that know me would not think I'm in any way arrogant. That is a total crap copout and a sorry sorry thing to say to someone. The whole process is just random. I had PD's tell me post match that if I would have expressed more interest, that they would have loved to have gotten me, but assumed I wasn't interested. I just believed one program way, way too much, because I knew the people there. I'm done, just make sure you communicate your interest and dance the tune.

Being "competitive" doesn't mean an applicant deserves their top spots. Personality is huge. I realized this when a super "competitive" and also extremely knowledgable person I rotated with went unmatched. The thing is, he was super cocky and thought he was the $hit. Being "competitive" doesn't come with any guarantee. The "fit" is a huge concept discussed regularly on this board. It DOES have a big impact on where you match. This is not to say that the scramblers had bad personalities, they just didn't happen to choose programs that liked them most.


They are only doing what we do, trying to convince the other party that this is the place/person for them. It is trying to guarantee a high spot for both sides. It's dating of sorts.


It would be silly to believe such guarantees. You go out there and act all smiley regardless of where you think you are guaranteed a spot. This is just being smart.

Sorry Freestyle. Definitely not a personal attack. I just disagree with your points which are shared by many. I just think that anger towards the match process is due to emotion as opposed to logic often times. I could be very upset/angry at the situation if it turned out poorly too, I just don't think it is the process' fault.

As for "having you offers on the table" and conducting a match in that fashion... it would never be feasible, not to mention it would draw this process out for months and months.

 

[SolidGold]

Come on, why do people take posts so personally. I don't think anybody is singling anyone out here, more speaking in general terms.

Maybe if you think of EM as a competitive specialty like ENT or Urology, you'll understand that its not about personality or how random of a process it is. It comes down to people trying to match when there are a significant number of applicants above the number of available spots. Not everyone is going to match in their top choices simply because there are too many people trying to get a limited amount of spots.

 

[trkd]

I appreciate your sorry flaming post trying to rub salt in peoples wounds. Don't even try to insinuate that I didn't get my top choice(s) because of personality conflicts or fit issues. People that know me would not think I'm in any way arrogant. That is a total crap copout and a sorry sorry thing to say to someone. The whole process is just random. I had PD's tell me post match that if I would have expressed more interest, that they would have loved to have gotten me, but assumed I wasn't interested. I just believed one program way, way too much, because I knew the people there. I'm done, just make sure you communicate your interest and dance the tune.

Whoa, whoa, whoa buddy. I think I need to address this right away. I am in no way insinuating any such thing. I didn't get my top choice either. I am nonetheless happy where I am. As I said in my post, "This is not to say that the scramblers had bad personalities, they just didn't happen to choose programs that liked them most." That is verbatim and applies for people who didn't get their top choices, like me. My example was to highlight the fact that competitiveness doesn't provide a guarantee. Nothing more. AND, people who know me on and off this forum know that I am far from trying to rub salt on people's wounds. I have continued to express sympathy for those that didn't match and have tried (and am continuing to try) to help a few of my friends get a spot after the match. So seriously relax. And lastly, I stated specifically that my post was not a personal attack. I just disagreed.

We are professionals here. We should be able to agree to disagree. I was in no way "flaming". Sorry if my post was ill received. It was not my intent.

 

[JBlue]

My question is how do you decide which interviews to go on? If you look good on paper and apply broadly to 40-60 programs but only interview at the most competitive ones, even if you interview at 10 of them, won't that effect the outcome just because those programs are going to have lots of great applicants to choose from? Do you try to interview broadly as well?

 

[Freestyle22]

I'll take that, but you've get to admit that when you have to preface your text as saying "this is not a personal attack" that you understand that some of the comments in it could be perceived as such. Lets forget it and move on.

 

[trkd]

I'll take that, but you've get to admit that when you have to preface your text as saying "this is not a personal attack" that you understand that some of the comments in it could be perceived as such. Lets forget it and move on.

I meant the "not a personal attack" thing sincerely. I am sorry it was not understood as that. Happy to move on.

 

[AR1776]

My question is how do you decide which interviews to go on? If you look good on paper and apply broadly to 40-60 programs but only interview at the most competitive ones, even if you interview at 10 of them, won't that effect the outcome just because those programs are going to have lots of great applicants to choose from? Do you try to interview broadly as well?

If you're lucky enough to get more interviews than you can go on then I would chose some in various catagories of competitiveness. That would also imply that you apply to a variety of different types of competitive EM programs.
I kinda think that those who did not match that weren't couples matching had some pretty big names on their ROL. Maybe if they had 1 or 2 programs that weren't in the top 20 EM programs they might have matched.
Who really knows, but I think that many SDN applicants that don't have as good of numbers (like me) as some who didn't match would say apply broadly and have a rockin' personality because that will play into the interview alot!

 

[met19]

My question is how do you decide which interviews to go on? If you look good on paper and apply broadly to 40-60 programs but only interview at the most competitive ones, even if you interview at 10 of them, won't that effect the outcome just because those programs are going to have lots of great applicants to choose from? Do you try to interview broadly as well?

interview at places you want to go. And 40-60 apps will be mad $$$$. E.g. if you really dislike cincinati or new york, don't interview at those programs unless you fell your short in the number of offers. I only went to places I could see myself living there. Then you can add in the 3 vs 4 issue. etc.....

I think Quinn had an excellent sticky on number of apps and how to decide where to apply.

 

[trkd]

My question is how do you decide which interviews to go on? If you look good on paper and apply broadly to 40-60 programs but only interview at the most competitive ones, even if you interview at 10 of them, won't that effect the outcome just because those programs are going to have lots of great applicants to choose from? Do you try to interview broadly as well?

Yes, interview broadly as well. Interview at safe schools just in case. Better safe than sorry. It will just take a few extra days of your time and couple hundred out of your wallet. It will be worth it.

 

[CueDoc]

This thread has gotten crazy. Let me set this straight. What I call the magic number is a number that, according to NRMP statistics, if you rank that many programs regardless of competitiveness you have at least a 99.5% chance at matching. If you look at the data table released by NRMP, that number was 10. EVERYONE who ranked 10 programs or more MATCHED. Granted it was not all at their number one places, but matched all the same. Interestingly, No one has offered up a number yet just alot of debate about what the magic number means and some ancillary "flaming" etc. I personally think the "magic number" is going to be 14. but thats just my thought

 

[wadoc]

With every program seeing a +15% increase in applications and only 6 unfilled spots in the country, this has been the most competitive year in the history of the specialty.

Do we have the NRMP's number for how many total people applied to EM this year?

 

[SolidGold]

Do we have the NRMP's number for how many total people applied to EM this year?

I think we are all waiting for that number. I haven't found it anywhere, neither for past years despite people mentioning that it exists.

 

[EM_Rebuilder]

This thread has gotten crazy. Let me set this straight. What I call the magic number is a number that, according to NRMP statistics, if you rank that many programs regardless of competitiveness you have at least a 99.5% chance at matching. If you look at the data table released by NRMP, that number was 10. EVERYONE who ranked 10 programs or more MATCHED. Granted it was not all at their number one places, but matched all the same. Interestingly, No one has offered up a number yet just alot of debate about what the magic number means and some ancillary "flaming" etc. I personally think the "magic number" is going to be 14. but thats just my thought

There still was .5% of people that ranked 10 and did not match. There were over one thousand spots in EM this year, correct? So there should still be 5 or 6 people that ranked 10 or more not match. I believe two of the people on here fit that bill, question is, where are the other 3-4???

I bet the percentages are still near the same....

 

[nocallaochicas]

Here are two thoughts:

1. I ranked 12 programs this year and did not match. So, assuming a magic number definition using 100% matched, then the number is at least 13 this year. For practical purposes (i.e., using 99.5%), the magic number is still >12; unless I am the 0.5%. (Note, I really believe in the apply and rank programs of all levels advice.)

2. My advice to people applying next year: If you apply to 234 programs and therefore interview for prelim and transitional spots, put those spots at the bottom of your rank list (not just on supplemental lists). The available prelims and transitionals in the scramble suck and trying to scramble into one of the very few EM spots is very hard. In fact, I would say to even those who aonly apply to 1-3 or 1-4 porgrams, interivew at one or two prelims just in case.

Of course, this is assuming that the EM match this year was not just an a blip.

ncc

 

[nocallaochicas]

duplicate post, sorry

 

[nocallaochicas]

There still was .5% of people that ranked 10 and did not match. There were over one thousand spots in EM this year, correct? So there should still be 5 or 6 people that ranked 10 or more not match. I believe two of the people on here fit that bill, question is, where are the other 3-4???

I bet the percentages are still near the same....

I doubt they are the same. It seems unlikely that 2 of 5 of all the people ranking 10 programs are SDNers. There just aren't that many SDNers relative to the total number of people applying for EM spots.
ncc

 

[roja]

I appreciate your sorry flaming post trying to rub salt in peoples wounds. Don't even try to insinuate that I didn't get my top choice(s) because of personality conflicts or fit issues. People that know me would not think I'm in any way arrogant. That is a total crap copout and a sorry sorry thing to say to someone. The whole process is just random. I had PD's tell me post match that if I would have expressed more interest, that they would have loved to have gotten me, but assumed I wasn't interested. I just believed one program way, way too much, because I knew the people there. I'm done, just make sure you communicate your interest and dance the tune.

The match is an incredibly stressful environment. And online communications can sometimes be difficult to get at the tone, or to misinterpret. I don't think ANYONE in this forum (caveat: who posts regularly) would ever do this. We spend our time on this forum as members of a community, assisting and helping others, regardless of thier level.

Most of us have established friendships with several woh didn't match. You really do a disservice by calling someones character into doubt like that.

trkd offers sage advice. "Fit" is very important. I have interviewed for four years now. I have seen phenomenally 'competitive' applicants: board scores higher than I knew they went, gpa's through the roof, strong LOR. However, they were often placed into 'no rank' spots on our list because of exactly that... the general consensus being that they wouldn't fit well with our program.

Coming back for second looks, thank you notes (which usually don't even get read), these things make no difference in ranking order.

Now, this is my program. There are others that aren't like this, but FIT is very important.

The other question, is what advice were you given? were you lead astray? this is not an issue of the match but of poor advice being given. There is so many terrible pieces of advice out there, that its hard to now what to do....

I certainly hope next year is better for you.

 

[Dr. Caveman]

This is the number one argument against a "competitive" applicant that doesn't match or goes down their list and I think its weak. Now granted we all know some real jerks out there but still I don't think that all these competitive applicants are jerks... As for "personality" I don't think it should out weigh clinical knowledge to the proportion that it seems to get on SDN, SLORs, "Clinical grades" etc...For instance I am confident that many of us know people that got Honor clinical grades via great evals due to proper smooching but had avg to below avg shelf scores....personally I'd rather have the kid that got the High Pass treat me if they killed the shelf (their knowledge is better) but hey that honors kid knew how to smooch, I don't know whats more important? disclaimer (that's not how everyone gets honors, I know)

But still if personality was the focus of medicine over intelligence than many of the people in medicine wouldn't have gotten into medical school. Most med students weren't the frat guys but the bio teaching assistants and often the frat guys in medicine feel out of place their "personalities" are a minority in the field, except maybe ours I think personality is important but is too subjective and it shouldn't out way knowledge when it comes to the match...the nicest doctor in the world isn't worth much if they can't think sharply, diagnose and treat. The ultimate is a resident with both.

ps. as for knowledge I do think our boards are pretty good gauges of clinical intelligence

Being "competitive" doesn't mean an applicant deserves their top spots. Personality is huge. I realized this when a super "competitive" and also extremely knowledgable person I rotated with went unmatched. The thing is, he was super cocky and thought he was the $hit. Being "competitive" doesn't come with any guarantee. The "fit" is a huge concept discussed regularly on this board. It DOES have a big impact on where you match. This is not to say that the scramblers had bad personalities, they just didn't happen to choose programs that liked them most.


They are only doing what we do, trying to convince the other party that this is the place/person for them. It is trying to guarantee a high spot for both sides. It's dating of sorts.


It would be silly to believe such guarantees. You go out there and act all smiley regardless of where you think you are guaranteed a spot. This is just being smart.

Sorry Freestyle. Definitely not a personal attack. I just disagree with your points which are shared by many. I just think that anger towards the match process is due to emotion as opposed to logic often times. I could be very upset/angry at the situation if it turned out poorly too, I just don't think it is the process' fault.

As for "having you offers on the table" and conducting a match in that fashion... it would never be feasible, not to mention it would draw this process out for months and months.

 

[deleted77919]

I recently went to a conference where 4 PD's from NYC programs spoke. Two said things that stood out to me.

One PD said stright up that there are people who do away rotations in his department who earn an honors grade. This grade is determined using as objective means as are available. There is a standard if a student exceeds he or she will earn an honors grade. But a number of these people are not invited to interview because the department does not feel that person is a good match for the program. He seemed to think that fit was really important.

Another PD said they completely ignore things like lettesr saying the program is someone's number one, etc. Letters like these make no difference to him.

Just some thoughts from two PDs I heard speak. Take it FWIW.

 

[Dr. Will]

This is the number one argument against a "competitive" applicant that doesn't match or goes down their list and I think its weak. Now granted we all know some real jerks out there but still I don't think that all these competitive applicants are jerks... As for "personality" I don't think it should out weigh clinical knowledge to the proportion that it seems to get on SDN, SLORs, "Clinical grades" etc...For instance I am confident that many of us know people that got Honor clinical grades via great evals due to proper smooching but had avg to below avg shelf scores....personally I'd rather have the kid that got the High Pass treat me if they killed the shelf (their knowledge is better) but hey that honors kid knew how to smooch, I don't know whats more important? disclaimer (that's not how everyone gets honors, I know)

But still if personality was the focus of medicine over intelligence than many of the people in medicine wouldn't have gotten into medical school. Most med students weren't the frat guys but the bio teaching assistants and often the frat guys in medicine feel out of place their "personalities" are a minority in the field, except maybe ours I think personality is important but is too subjective and it shouldn't out way knowledge when it comes to the match...the nicest doctor in the world isn't worth much if they can't think sharply, diagnose and treat. The ultimate is a resident with both.

ps. as for knowledge I do think our boards are pretty good gauges of clinical intelligence

I agree with you to an extent. I once asked a PD on an interview what she looked for in her residents. She said one thing..."someone that works hard, b/c I can train anybody." So in this case, "fit" becomes a huge factor into whether that person will be ranked highly or not. Many of these faculty members interviewing you want to find out whether you are the type of person they want to work a 12 hour overnight shift with. Are you somebody that will make it a fun/worthwhile shift? The fact that you are there for the interview implies you can do the work since you've survived their "screening" process. So while there may be someone who has better board scores or grades, they may not come off as the type of person that would vibe with the style of the program. That's just the reality of it, and the power that each program has over the applicant in the end.

 

[FoughtFyr]

This is the number one argument against a "competitive" applicant that doesn't match or goes down their list and I think its weak. Now granted we all know some real jerks out there but still I don't think that all these competitive applicants are jerks... As for "personality" I don't think it should out weigh clinical knowledge to the proportion that it seems to get on SDN, SLORs, "Clinical grades" etc...For instance I am confident that many of us know people that got Honor clinical grades via great evals due to proper smooching but had avg to below avg shelf scores....personally I'd rather have the kid that got the High Pass treat me if they killed the shelf (their knowledge is better) but hey that honors kid knew how to smooch, I don't know whats more important? disclaimer (that's not how everyone gets honors, I know)

But still if personality was the focus of medicine over intelligence than many of the people in medicine wouldn't have gotten into medical school. Most med students weren't the frat guys but the bio teaching assistants and often the frat guys in medicine feel out of place their "personalities" are a minority in the field, except maybe ours I think personality is important but is too subjective and it shouldn't out way knowledge when it comes to the match...the nicest doctor in the world isn't worth much if they can't think sharply, diagnose and treat. The ultimate is a resident with both.

ps. as for knowledge I do think our boards are pretty good gauges of clinical intelligence

I've got to weigh in here. There is a person that I interviewed for a residency spot in our program. His board scores were good, his grades were decent and his letters were very good to outstanding. His interview went fine. Not "oh my God, we've got to have him", but certainly not "keep him out" by any means. Across the board, we liked him. He ended up in what we would've thought was a competitive position on our list. We "went shallow" and didn't make it down to this individual. I know for certain that he ranked >10 programs and had to scramble. Prior to the match, I'd have bet you a paycheck that he would find a position, but he didn't. I can't tell you why. Call it "personality", call it "chance", call it whatever you'd like. But on some level it is an intangible that you can't explain. Was my example applicant statistically worse than all those ranked above him - no. Was he better than all those ranked below him - no. He was a good to great applicant who caught a VERY bad break. This has always been the story in the uber-competitive specialties. It may become the case in ours.

- H

 

[trkd]

I agree with you to an extent. I once asked a PD on an interview what she looked for in her residents. She said one thing..."someone that works hard, b/c I can train anybody." So in this case, "fit" becomes a huge factor into whether that person will be ranked highly or not. Many of these faculty members interviewing you want to find out whether you are the type of person they want to work a 12 hour overnight shift with. Are you somebody that will make it a fun/worthwhile shift? The fact that you are there for the interview implies you can do the work since you've survived their "screening" process. So while there may be someone who has better board scores or grades, they may not come off as the type of person that would vibe with the style of the program. That's just the reality of it, and the power that each program has over the applicant in the end.

I agree completely. One PD whom I respect very much said that he can train anyone but does he want to hang out with them for 3 year. I am not saying that absolutely anyone can make up for failing both boards, etc by just having a great personality. I am saying that some has avg boards but awesome personality while the other has stellar boards, etc and an OK personality, many places seem to choose the awesome personality as long as the rest of the app is "adequate". Awesome personality is very subjective but what I mean is awesome in the eyes of the program.

Furthermore, at a program that takes 10 per year, if a scrambler was next in line after #10 and this happened at all the programs that person ranked, then they would go unmatched. It is likely that very little was different about this person than #10 that matched. Unfortunately that is how it goes. Someone probably saw this person as a bit better of a fit. Unfortunate but true, like FF's example above.

 

[Sweet Tea]

For what it's worth, I ranked 11 programs (10 EM, 1 IM prelim) and didn't match. 1 of my classmates ranked 11 EM programs and didn't match, another one was AOA, ranked 15 programs, and no match for him either.

I'll be very curious to see this year's "magic number". I know for certain that it's going to be impossible to go on 12 interviews again this year like I did last year; a surgery prelim year just won't allow that kind of thing.

 

[Apollyon]

I know for certain that it's going to be impossible to go on 12 interviews again this year like I did last year; a surgery prelim year just won't allow that kind of thing.

As I said to another person who scrambled into prelim surgery (instead of prelim IM), who had a reason that I thought might be questionable, I hope that doing prelim surgery instead of IM doesn't come back to bite you in the ass.

 

[blackbird03]

I have no idea why this year was so competitive. But I can say that you can't bet on a magic number because next year might even be more competitive. Are we catching up to radiology?

 

[Sweet Tea]

As I said to another person who scrambled into prelim surgery (instead of prelim IM), who had a reason that I thought might be questionable, I hope that doing prelim surgery instead of IM doesn't come back to bite you in the ass.

That makes 2 of us.

 

[DOCOFMED07]

I have no idea why this year was so competitive. But I can say that you can't bet on a magic number because next year might even be more competitive. Are we catching up to radiology?

Maybe, but I don't think so! I think there's just this overall surge in residency applications. I mean, look at OB. It too had a 99.5% match rate! That's absurd! Is it now as competitive as, say, EM? I wouldn't have thought so but apparently everyone's been bitten by this "medical doctor" bug.... Perhaps that which was once considered less competitive will now be more competitive as more applicants think they have a better chance because it was at one time less competitive.... I dunno. It's late.

 

[LHCF]

For what it's worth, I ranked 11 programs (10 EM, 1 IM prelim) and didn't match. 1 of my classmates ranked 11 EM programs and didn't match, another one was AOA, ranked 15 programs, and no match for him either.

I'll be very curious to see this year's "magic number". I know for certain that it's going to be impossible to go on 12 interviews again this year like I did last year; a surgery prelim year just won't allow that kind of thing.

I actually know someone who went on 11 interviews during a surgery prelim year. Just let your chief resident know your situation in advance and be very nice to your fellow interns e.g. offer to take call for them so that they can cover you later.

 

[Haemr Head]

The Match isn't random, it's capricious.

Where you match on the list and whether you match at all, will have nothing to do with future potential as a physician or a leader in the specialty. It's not about who can do the job, it's about who can get the job. Many very good people are unfairly hurt by the process. The problem is (to steal from Churchill), it's the worst system except for all the others.

Not only are the total number of applicants rising but also the number of people who at the top of their class with lots of extracurriculars. It's really not rocket science: transcripts-Dean's letters, 3rd year clinical rotations, and winning olympic gold medals, gets you the invite and defines how competitive you are.

Love letters and declarations to PDs about their program being #1 may have a small effect with very insecure PDs who want to go as shallow as possible on their list, but the rather sizeable number of PDs I know would never use this as a criteria to rank an applicant.

So how do you get the job? If you put 10+ programs on your list and did not match, it may well be that you were just under the wire at all those programs. This year was horrible but I would still consider that a diagnosis of exclusion. It may be that there is something in your application that looks inoffensive to you but is a red flag to a PD. Or you were not quite as charming as you might think in the interviews. Being interviewed does not necessarily correlate with your overall popularity or interpersonal skills. Find an advisor who's own interpersonal skills are somewhere below House so that they will give you the straight scoop, and honestly determine what your liabilities are. Once you understand these, there are ways to address them and boost your competitivity and find a home.

This year has shown that no one is safe and that the magic number is only helpful if you can get in a time machine and apply in last year's Match. From now on, I intend to recommend ranking at least 15 programs with a couple of less desireable and competitive ones as safety spots. No matter how great an application or how competitive an applicant, ranking <6 programs offends the Gods and is asking for trouble. Finally, I agree that the couples match is tempting the fates. Personally I say distance makes the heart grow fonder, and if you can't be with the one you love, love the one you're with.

 

[SolidGold]

Being interviewed does not necessarily correlate with your overall popularity or interpersonal skills. Find an advisor who's own interpersonal skills are somewhere below House so that they will give you the straight scoop, and honestly determine what your liabilities are. Once you understand these, there are ways to address them and boost your competitivity and find a home.

This year has shown that no one is safe and that the magic number is only helpful if you can get in a time machine and apply in last year's Match. From now on, I intend to recommend ranking at least 15 programs with a couple of less desireable and competitive ones as safety spots. No matter how great an application or how competitive an applicant, ranking <6 programs offends the Gods and is asking for trouble. Finally, I agree that the couples match is tempting the fates. Personally I say distance makes the heart grow fonder, and if you can't be with the one you love, love the one you're with.

This is sound advice, and even though I'm only a lowly future PGY1 and not a PD, I was going to suggest to anyone who may have asked me the same thing. I especially think that ranking all the programs you've interviewed at may begin to become more important since going to a less desirable place almost certainly is better than scrambling. Going to a minimum of 12-15 interviews may be needed even if you are AOA, got a 260 on step 1 and step 2, and went to Africa and found the cure for AIDS. Going to less competitive places as well will only help an applicant like that too. It's all about "fit" for the programs, just like it was all about "fit" when we came up with our own rank order lists. And if a program, I don't care if it's the most competitive program out there or the least, doesn't think you'll "fit" with the program, you might be ranked below that line in which they filled which may have been pretty high and made you very competitive to match in the past.

And I agree with getting a straightforward honest assessment of your liabilities from your mentor or anyone you work with who you know will be honest. My own advisor was a straight-shooter and gave me good honest feedback, so I worked on that and was able to improve any weaknesses before I had for my 2 away rotations. I didn't think I had any weaknesses because I was getting great evaluations and got along with everybody, but that doesn't mean that I was perfect, or even what she perceived as a perfect "fit" for this program. Get honest feedback, and I bet that you'd be surprised by what someone tells you even if you had great evaluations, got honors, and they agreed to write you a strong SLOR. They may be agreeing to do it because they think you'll be a great EP, but that doesn't even mean that they think you'll be a good "fit" with their program. This happened to many this year who got awesome feedback and support from their home program, but didn't match at their home program either. It doesn't mean they didn't like you, because they did spend the time to write a great SLOR and help you do the best through the entire process, it might have meant that when it came time for them to put their ROL together, you were not as good of a "fit" as people they may have ranked higher. You still could have been ranked in a great position to match based on previous years, but this year was more competitive. Now i've seen people here say that this year wasn't more competitive, and argued that it was just the fact that there were probably more applicants trying to get into EM, or just more applicants overall in medicine (DO's crossing over, more IMG's, and just more med students). Doesn't that mean it got more competitive?

Now, I hated the word "fit" because I heard it at the majority of programs I visited, but when it came time to develop my ROL I realized that "fit" was THE deciding factor. And I don't think it's any different for the PD's out there.

 

[Freestyle22]

I certainly hope next year is better for you. [/quote]

Dont worry about me, I matched. I just want people to take everything anyone tells you, even if it is from your own program that says you will match there, with a grain of salt.

Fit is an extremely vague concept, that someone tries to size up in 15 minutes or so when speaking to you. Anyway, I tend to believe the poster that indicated that there are excellent applicants that will catch a bad break, whether this is just random or just by believing bad advice/promises from programs, advisors, or this vague fit concept, I just dont know. I'd just apply to more programs, and not be complacent about it. This field is getting very competitive, and your intelligence and work ethic, will help you only to an extent, and then it becomes political with the smoosing of trying to convince the guy across from you that you are someone that he would like to be buddies with, and even if you think you did, you never know.

 

[bulgethetwine]

I actually know someone who went on 11 interviews during a surgery prelim year. Just let your chief resident know your situation in advance and be very nice to your fellow interns e.g. offer to take call for them so that they can cover you later.

This makes me wonder if you're either not yet a resident, or have been out for some time. I mean, I'm not trying to flame you by either insinuation, but in the current climate of q3 or q4 call on most rotations, in the context of an 80 hour work week limitation, do you really think you can just "offer to take call" on a casual basis?

In actuality, the schedules are very tight with the work hour restrictions. It's next to impossible to get one switch in a month unless people don't mind you working q2 occassionally (which sucks from a lifestyle point of view).

Seriously. Don't do the surgery prellim year if you're already planning on something else. It's a waste. You will in fact NOT get particularly good at procedures -- you'll get great at paperwork and scut. You'll get more procedures than maybe an internal medicine prelim would, but not by much -- and certainly not enough to be any more comfortable than any other PGY 1 in EM. You'll be PULLING chest tubes, and PULLING lines, but you won't be doing a whole lot of 'em.

Again, not trying to flame anyone, but for those of you about to start a prelim year who didn't get in this time and are (quite reasonably and sensibly in my opinion) going to try again next year, I hope you take this, and advice from others like Apollyon in this regard, to heart.

 

[Dr. Caveman]

Haemr Head, Solid Gold, and Dr. Will...great posts I think it is important for future applicants to see that although we are all happy with matching (some with our #1's some without) that the match can not be "rigged" and that you can do everything 'right', dot all the i's and cross all the t's and still not end up at your top place.

What I've taken from this forum is that there is a touch of randomness to the process....call it "personality", "fit", "trainablility", etc but don't take it personally ....just because you didn't match somewhere doesn't mean you weren't competitive, weren't liked, weren't ranked to match...you could've been all that and more but the class filled at 13 and you were ranked 14 which is a position that made it in all previous years This has been a good discussion....a final note: I give all those who scrambled my highest respect...that must be incredibly difficult and I admire you courage in facing it and openly discussing it on SDN...I would like to train with people with your character.

 

[EMedGrrl]

The NRMP numbers are out (look in the ERAS and the match thread for the file - I couldn't figure out how to copy and paste it).

EM programs ranked 10.3 applicants per position filled.

So ... assuming perfect statistics, if programs are ranking 10-11 applicants per slot, then applicants should be able to rank 10-11 programs, and everyone would find a spot.

Of course, that presumes that all of the EM applicants aren't ranking the same 10 programs ...

http://forums.studentdoctor.net/attachment.php?attachmentid=7956&d=1174491587

 

[LHCF]

This makes me wonder if you're either not yet a resident, or have been out for some time.

Thanks, but I actually AM an intern doing Q4 call. My friend who I wrote about is actually a surgery intern doing Q3 call. Like I said, she was able to go on 11 interviews.

 

[Dr.Evil1]

I know that some people would disagree but in my mind the match is the best system out there for the APPLICANTS. Granted it didn't work out well this year for some of SDNs finest but by in large it is much better than the alternatives. Just think of a system without a final national matching system. You would place all the power in the hands of the PROGRAMS who would then have the only card to play. Much the way some are accusing Vegas of playing the system (ranking very few and then getting the best of the unmatched in the scramble) it would be chaos.

 

[Janders]

The NRMP numbers are out (look in the ERAS and the match thread for the file - I couldn't figure out how to copy and paste it).

EM programs ranked 10.3 applicants per position filled.

So ... assuming perfect statistics, if programs are ranking 10-11 applicants per slot, then applicants should be able to rank 10-11 programs, and everyone would find a spot.

Of course, that presumes that all of the EM applicants aren't ranking the same 10 programs ...

http://forums.studentdoctor.net/attachment.php?attachmentid=7956&d=1174491587

Sadly, the stats don't quite work like that. EM programs ranked 10.3 applicants per spot filled; that just tells us how long there rank lists were versus spots. We still haven't gotten the full statistics like we did last year, which gave a % match rate versus number of programs ranked by applicant. That is the chart you want to find a "magic number" of programs needed to rank to ensure match. However, as we saw this year, there is little use to that if one year is much harder than than the last. Apparently the number must be over 13... which is getting kind silly, considering interview logistics, etc. We might be a competitive enough specialty now that there is no perfect number. If you find my post about this from a couple months ago (i'll link to it later when i have a chance to surf), you can find the stats and see that specialties like derm don't have a number above which 100% (effective) of applicants match.

 

[Janders]

Here is my earlier post and a link to the file that had extended info on the previous years match. Not sure when this info is released for the current match data.

http://forums.studentdoctor.net/showthread.php?p=4453029#post4453029