who else is indecisive/commitmentphobic?

[meowkat444]

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I basically know what my first choice is; it's been my first choice for over a year. But I just couldn't write a letter of intent; only a letter of interest. I would feel like I'm getting engaged after one date...

Anyone else feel this way? I'm annoyed with myself because I fear that not writing a letter of intent will definitely affect my chances of getting in there. Can't do it, though.

Sigh.

 

[seraph524]

Yea...its the finality of the choice thats scary...

 

[j-weezy]

http://www.nytimes.com/2008/02/26/s...&ex=1204261200&en=c56122843b1ec447&ei=5087%0A

 

[meowkat444]

yep, my mom sent me that 😉

 

[EpiGirl]

I think the residency match system was designed partly because of this being a very common problem. Anyone know a lot about game theory? I think it's related.

In any case, I hear you. I wish I could go to every school. In fact, I get hurt when my friends bag on the schools I'll be rejecting, and I start to worry about the school's feelings. 😉

 

[Neuronix]

According to discussions with adcoms at a few different places, letters of interest don't do anything to help you get admitted. The difference is that a letter of intent clearly states "I WILL COME IF I'M ACCEPTED". A letter of interest doesn't say that.

Note: I've gotten a number of PMs over the last year asking me how much the letter of intent matters and when it should be sent. I don't know the answer to that question. Your guess is as good as mine.

I think the residency match system was set up to make it impossible for medical students to negotiate things like salary, work conditions, etc etc etc. It's a monopoly system that is not in the applicant's favor at all. There was an anti-trust lawsuit and Bobby Kennedy wrote a rider into an unrelated bill essentially exempting the match from lawsuits. It's an evil, dirty business, given that residents prop up the academic healthcare system and it's IMO a form of inhumane indentured servitude to force someone to work >80 hours a week for many years. Make no mistake, the 80 hour work rules are kind of a joke and are poorly enforced. There are no whistleblower protections, so if you report a program they WILL find you and throw you out of your residency.

 

[QofQuimica]

In any case, I hear you. I wish I could go to every school.

That was how I felt, too. I was accepted to twelve schools and would have happily attended any of them. Even after I was sure I wouldn't going to go to School A over School B, I still disliked withdrawing. Withdrawing was an even worse feeling than being rejected, no question about it. The thing is, you work d*** hard to get those acceptances, and there you have to turn around and give up something valuable like a medical school seat after you worked so hard to get it. Sure, it's a good problem to have, but it's not a fun problem to have.

In the end, I wound up picking the school that gave me the most financial aid. It also happened to be the program I liked best for the curriculum. But I am a very practical person, and there is no question that I would have withdrawn here and gone to a school with a better aid package if this school hadn't at least matched the other scholarships I already had been offered. Cost was my most important consideration, but of course it's not even an issue for most of y'all. I think if I were applying to MSTPs, I'd probably pick based on geography assuming all else (ex. research opportunities, curriculum) was equal. It seems kind of trivial on one hand, but it's not like there's any more practical reason than geographical location for picking, say, Duke over Stanford or vice versa.

 

[meowkat444]

I've always wondered if/why a letter of interest would actually help, since it's not a commitment at all. I think you would have to be pretty concrete about why it's not a letter of intent.

Thanks Q. I mean, in the end, there are no wrong choices... It's just a lot of years, you know? And I do think that most of my warm fuzzy feelings are based on geography right now, not the curriculum/program.

 

[QofQuimica]

Thanks Q. I mean, in the end, there are no wrong choices... It's just a lot of years, you know? And I do think that most of my warm fuzzy feelings are based on geography right now, not the curriculum/program.

You're from CA. Assuming your family/friends/partner/other support system are in CA, I'd choose Stanford if it were me. I wouldn't want to have to make that cross-country trip every time I feel like getting out of here and going home. Plus, I'm sure that I don't have to tell you that cross-country tickets are pretty expensive unless you get lucky (not likely for holidays like Christmas and Thanksgiving.) As a busy grad and med student, there really is a lot to be said for being close enough to drive or jump on a 40 minute flight for a weekend trip whenever you need one.

I know it sounds like a long time, but once you start, you'll be amazed how fast the time flies by. (Well, maybe not your grad school years, but the med school years anyway. 😛 ) Seriously, it seems like yesterday I was just applying to med school, and now I'm finishing my second year. It recently hit me that I don't have too much longer until I'll have to start thinking about applying for residencies and/or post docs. 😱

 

[gbwillner]

I basically know what my first choice is; it's been my first choice for over a year. But I just couldn't write a letter of intent; only a letter of interest. I would feel like I'm getting engaged after one date...

Anyone else feel this way? I'm annoyed with myself because I fear that not writing a letter of intent will definitely affect my chances of getting in there. Can't do it, though.

Sigh.

Of course you're indecisive- you couldn't make up your mind if you wanted a PhD or an MD... and now you're just prolonging the decision another 8-10 years!

 

[meowkat444]

You're from CA. Assuming your family/friends/partner/other support system are in CA, I'd choose Stanford if it were me. I wouldn't want to have to make that cross-country trip every time I feel like getting out of here and going home. Plus, I'm sure that I don't have to tell you that cross-country tickets are pretty expensive unless you get lucky (not likely for holidays like Christmas and Thanksgiving.) As a busy grad and med student, there really is a lot to be said for being close enough to drive or jump on a 40 minute flight for a weekend trip whenever you need one.

I know it sounds like a long time, but once you start, you'll be amazed how fast the time flies by. (Well, maybe not your grad school years, but the med school years anyway. 😛 ) Seriously, it seems like yesterday I was just applying to med school, and now I'm finishing my second year. It recently hit me that I don't have too much longer until I'll have to start thinking about applying for residencies and/or post docs. 😱

Actually, i'm from west virginia, but love the west coast (much to my family's dismay), and I still haven't heard from one school that i adored on the east coast (that really likes letters of intent, but i just don't feel like i could write one to any school right now). So that doesn't help much. Sigh. I really appreciate the personalized advice though! You are the best 🙂 I'm sure in hindsight it won't seem as big of a deal as it does, coming up ahead.

 

[solitude]

According to discussions with adcoms at a few different places, letters of interest don't do anything to help you get admitted. The difference is that a letter of intent clearly states "I WILL COME IF I'M ACCEPTED". A letter of interest doesn't say that.

Note: I've gotten a number of PMs over the last year asking me how much the letter of intent matters and when it should be sent. I don't know the answer to that question. Your guess is as good as mine.

Really? You would know better than me, but I just wanted to throw out my two cents that I have heard from at least two adcoms that letters of interest can actually make a sizable difference. I get the sense that letters of interest benefit an applicant in an institutionalized way, but they can make a subconscious difference in two ways: it's assumed that an applicant doesn't send them to every school, so they do really indicate interest or even quasi-intent (non-binding of course); the applicant can highlight how the school matches their strengths in a way that may not have otherwise been possible or obvious. FWIW, this info comes straight from the head administrators at two "top 10" programs (of course I'd rather not say which ones). I'm sure it varies from school to school, though, and it sounds like some schools don't even bother reading them?

 

[solitude]

I think the residency match system was set up to make it impossible for medical students to negotiate things like salary, work conditions, etc etc etc. It's a monopoly system that is not in the applicant's favor at all. There was an anti-trust lawsuit and Bobby Kennedy wrote a rider into an unrelated bill essentially exempting the match from lawsuits. It's an evil, dirty business, given that residents prop up the academic healthcare system and it's IMO a form of inhumane indentured servitude to force someone to work >80 hours a week for many years. Make no mistake, the 80 hour work rules are kind of a joke and are poorly enforced. There are no whistleblower protections, so if you report a program they WILL find you and throw you out of your residency.

Why is there no whistleblower protection? That's sort of absurd. Also, exactly how prevalent are 80+ hr work weeks for residents? All the attendings I've talked to lately love to wax poetic about their insane workloads as residents and downplay the workloads of current residents. I know some specialties like neurosurg and general surg are crazy intensive, but do most residents work this much?

 

[QofQuimica]

Actually, i'm from west virginia, but love the west coast (much to my family's dismay), and I still haven't heard from one school that i adored on the east coast (that really likes letters of intent, but i just don't feel like i could write one to any school right now). So that doesn't help much. Sigh. I really appreciate the personalized advice though! You are the best 🙂 I'm sure in hindsight it won't seem as big of a deal as it does, coming up ahead.

Ok, it says CA is your home state on your profile. But since you're from WV, now I'm going with Duke instead of Stanford. 😛

 

[LunderKind]

I feel you meowkat! I frequently relate to Elliot from Scrubs in this particular dilemma (and wonder how I'll be a doctor)...

Elliot: Oh, I've been trying to decide what drink to get. I've been standing here trying to choose between cherry soda and, uh, ginger ale. And you know what? It's a toss-up. I mean, either way I get a cold drink, right? And it would be almost impossible for me to kill someone with this decision, but... I still can't make it. I think I'm in trouble here.

Even simple decisions sometimes are a challenge. However, at least your choices are phenomenal! I don't think you will be able to make a bad decision, and, wherever you end up, I doubt you'll wish you had gone elsewhere instead.

 

[Neuronix]

Really? You would know better than me, but I just wanted to throw out my two cents that I have heard from at least two adcoms that letters of interest can actually make a sizable difference.

It's entirely possible I don't know better than you. The benefit of these letters likely does vary from place to place. Everything you send will end up in your file and will be read regardless. How much it matters depends on the adcom/school. Who knows what the reality is, as students at my school are not involved in MD/PhD admissions.

That being said I used to interview MD applicants. After well over half of interviews I got a "thank you" letter that looked like "thanks for interviewing me, now let me spend the rest of this page telling you I liked your school alot and telling you why I'm great". If you count that as a letter of interest, almost everyone is sending them. When everyone does something that isn't mandatory it becomes somewhat worthless imo.

Why is there no whistleblower protection? That's sort of absurd. Also, exactly how prevalent are 80+ hr work weeks for residents? All the attendings I've talked to lately love to wax poetic about their insane workloads as residents and downplay the workloads of current residents. I know some specialties like neurosurg and general surg are crazy intensive, but do most residents work this much?

Why? Who knows. This creates a system whereby residents are pressured by all sorts of influences to fake their hours in all kinds of ways (clocking out and staying, taking paperwork home with them, etc). This means of course the program says WE TOLD THEM TO GO HOME officially, but then the evaluations or opinions of the residents that aren't fighting to stay 120 hours a week are low. Current attendings can't be trusted to provide accurate information in this regard. Some don't have any control or interest in these issues, and so they don't really care or know the real situation. Program directors and such aren't going to be honest about this. Residents can't be honest about this either, because in residency particularly saying something negative about your residency is akin to shooting yourself. Who can you trust? Even the penalties for breaking the rules are akin to a slap on the wrist in my opinion.

But which residencies are breaking the rules? The ones that were typically above 80 hours to begin with. Pathology for example was never in danger of breaking 80 hours anyways. Medicine/Surgery internships and programs are the real offenders (not all programs are offenders of course, and I still think 80 hours is inhumane). Though, I have FMG friends in other specialties who are abused because they are FMGs and are tied to their residencies to stay here and such, who also go well over 80 hours a week.

Edit: For evidence of what I'm saying, see: http://drslounge.studentdoctor.net/showthread.php?t=499601

 

[solitude]

Why? Who knows. This creates a system whereby residents are pressured by all sorts of influences to fake their hours in all kinds of ways (clocking out and staying, taking paperwork home with them, etc). This means of course the program says WE TOLD THEM TO GO HOME officially, but then the evaluations or opinions of the residents that aren't fighting to stay 120 hours a week are low. Current attendings can't be trusted to provide accurate information in this regard. Some don't have any control or interest in these issues, and so they don't really care or know the real situation. Program directors and such aren't going to be honest about this. Residents can't be honest about this either, because in residency particularly saying something negative about your residency is akin to shooting yourself. Who can you trust? Even the penalties for breaking the rules are akin to a slap on the wrist in my opinion.

But which residencies are breaking the rules? The ones that were typically above 80 hours to begin with. Pathology for example was never in danger of breaking 80 hours anyways. Medicine/Surgery internships and programs are the real offenders (not all programs are offenders of course, and I still think 80 hours is inhumane). Though, I have FMG friends in other specialties who are abused because they are FMGs and are tied to their residencies to stay here and such, who also go well over 80 hours a week.

Interesting, thanks neuronix.