WTF? #8 choice in IM?

[RememberTheTime]

I'm a US Citizen, born and bred, excellent undergrad, american allopathic mid-tier med school, high-passed med clerkship, honored medicine AI, 97s and 98s on both steps and passed CS on first try and all of these facts trasmitted to programs before rank time. Have been told by nondiscreet interviewers that my letters are excellent.

I get my envelope today. I'm expecting to see #1 or #2. Mind you, none of these programs I'm ranking are Hopkins or MGH or UCSF or that whole thing where a #8 result is expected in IM. I saw my #8 and was frankly floored.

Anyone else in IM get so low on their rank list? Am I the only one? If so, do I get a special gold star because I am obviously so special?

AProgD - any ideas on WTF happened? Did my higher choices think i was too good for them, and thus ranked me lower, or did this happen because they thought I'd suck?

I am not at all unhappy with #8. I'm just bewildered! I thought most normal people get within their top 3 in IM?

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[ranmyaku]

Well... I feel for ya. I would have been floored too if I had gotten my #8. 82% overall matched into their top 3. Somebody's gotta be in that 18% who don't get the top 3.

Did you send a "I'm gonna rank you first" email to your top choice? Did you express some interest in your top 3 picks? Maybe you interviewed poorly and didn't know it?

 

[tibor75]

Maybe you came off in the interviews as cocky. You certainly do here.

 

[John Deere Gree]

Maybe you came off in the interviews as cocky. You certainly do here.

I would of be all right with my 8th spot (I ranked 10) if I had to go that far down my list. Sure my ego would be bruised, but hey, at least I wouldn't of had to scramble.

 

[DarthNeurology]

I'm a US Citizen, born and bred, excellent undergrad, american allopathic mid-tier med school, high-passed med clerkship, honored medicine AI, 97s and 98s on both steps and passed CS on first try and all of these facts trasmitted to programs before rank time. Have been told by nondiscreet interviewers that my letters are excellent.

I get my envelope today. I'm expecting to see #1 or #2. Mind you, none of these programs I'm ranking are Hopkins or MGH or UCSF or that whole thing where a #8 result is expected in IM. I saw my #8 and was frankly floored.

Anyone else in IM get so low on their rank list? Am I the only one? If so, do I get a special gold star because I am obviously so special?

AProgD - any ideas on WTF happened? Did my higher choices think i was too good for them, and thus ranked me lower, or did this happen because they thought I'd suck?

I am not at all unhappy with #8. I'm just bewildered! I thought most normal people get within their top 3 in IM?

I think everybody gets excellent letters, otherwise, why would you get a letter from someone who won't write you a good letter?

I think that if you had an honors in medicine this would have been the clincher. Some residency programs in IM use honors to screen applicants, and perhaps for ranking purposes as well.

 

[Weinberg Angle]

...

 

[asmallchild]

We had a lot of students at our school disappointed when applying for IM. It's especially odd considering that in years past, our IM PD had massive struggles convincing home students to stay at the home program. And it seems like this year, the opposite situation emerged where people wanted to stay but couldn't.

 

[t33sg1rl]

Wow, I'm really sorry! This is probably just one of those really odd statistical coincidences. I wouldn't take it personally and I definitely wouldn't go down the "what's wrong with me?" path. Unless, of course, your home school was in the first seven... then I'd suspect that someone important didn't like you and was out to get you.

 

[alittlestory]

I can sympathise- i'm in the same boat- totally and completely gutted. Thing is, i'm sort of ashamed-- kinda like a dog when they hang their head low. I'm not even proud of my match- and I can't help but think that THERE MUST HAVE BEEN A MISTAKE!

I can't talk to anyone about this, because well- I've been avoiding all the phone calls and text messages- I guess I'm dissapointed and even a bit embarassed at the outcome. I had huge expectations on myself- bottom line? Perhaps I didn't choose my ROL wisely.

No one really gets how i'm feeling- so I guess I'm looking for moral support.

Concise version? I matched at my #5. When I saw it, I was dumbfounded. All I kept thinking was there must be some sort of error...

My ROL
1) An ultra-ultra competitive specialty--- my only interview in that field- so I figured "all or nothing" I'd be an idiot not to rank them first.

2) Categorical Medicine at ---------:
- I aced my interviews, i left there beaming-- they contacted me TWICE after my interview asking me to "seriously consider them" and it was just great feedback... I'm absolutely shocked that I didn't match there. I was 90% certain I'd be in --------.

3) TY at ----------:
- yes, yes- I know... TY... It went along with my (#1)- and I honestly love this institution. My thinking was this: If i dont get ------ (my DREAM!) I might as well use this upcoming year to get practical experience, regroup- and reapply next year. A TY at ------ would have been great at opening doors for me to stay on with them... They offer virtually everything under-the-sun...(fellowship and residency wise) and I don't know, I just loved it.
-* I did NOT receive anyfeedback from them... so I wasn't expecting much.

4) Categorical IM at Univ. ---------
- Hey, who can argue with good weather and a big university program? Although i wasn't "in-love" there- I found it to be a wise choice.
- opportunities for fellowship abound.
- Again, great feedback from PD post-interview.

5) Categorical at community-university hospital in -------.
- Damn. DAMNIT! I honestly didn't think it would come down to this... I was deliberating between this and my #6...
- I chose based on the fact that
a) I was certain I would be in my top 3
b)---------is a great city. What a premature decision.
- I'm miserable- I cried all day yesterday. All i kept thinking was, " I worked my a** off for this!?!?!?!?!"
- How did I go from huge institutions with great opportunites for fellowships to this???
- What I hate:
* Only have IM residency (and Path, I think- they might also have rads fellowship)
* NO IM FELLOWSHIPS!!! although they do have good fellowship placement
* IN-TRANSITION: switching over sponsorship
* Facilities (sim-lab, library etc) aren't all that great
* emphasis on outpatient clinic (25% time spend there)
* Didn't get a great idea about didactics and teaching during my visit
BUT... everyone was friendly- residents seemed to have time to have a life outside of the hospital- good camraderie. And Hey- its -----.
- I just think that I could have done so much better for myself.

6) Categorical Med @ Banner ----------
- I really liked it here... was confused about placing this and #5.
- They have fellowships (loads) and other residency programs in the hospital
- I listened to my parents nagging about distance: afterall, that would mean relocating to the West-Coast.
- Other hesitatio? Not sure if this means anything- but their program is very DO and FMG heavy.

7) and 8) compare with where I matched.... Community-univ affiliated hospitals... no fellowships BUT they do have other residency programs.

I can't stop thinking about this- it was the last think on my mind last night--- and the first thought this morning. I was half-hoping that yesterday was a dream.

My thoughts are already revolving around:
- how can i get out of this?
- can I call the PD at ---- and pray for a miracle (visa fall thru etc)
- how difficult is it to transfer? how will that look on my CV (lack of continuity)
- ****!!!! I'm going to be miserable.

This is a time when I should be celebrating my accomplishments- and be beaming with pride. Instead- i'm so bummed. I'm even ashamed. and shocked.

People keep telling me that "there's a reason for everything" - but at this point- I'm so low in my thinking, I can't even see beyond the obvious. The next three months are going to be miserable. and i CANT STOP THINKING ABOUT IT!

Help- advice- anything. it's all appreciated.

 

[dragonfly99]

a littlestory,
the Match is over now.
You have a binding contract to the place where you matched, which honestly doesn't sound that terrible. Now you have to go there and bloom where you are planted...at least for a year. If you end up hating IM, you can try to bail at some later point, but everyone needs to do an intern year, so really you aren't in such a bad position.

As far as not getting Mayo, they don't really know who THEY are going to get, so likely to recruit heavily/call back anyone on the top 1/2 or so of their rank order list. They probably truly did like you, but likes some other people better. Transferring IM programs isn't totally impossible, so if you end up hating where you go, you can probably bail at some point. Usually, people end up liking where they go and end up not transferring.

 

[analgold09]

While I did not go as far down as #8, I was a little disappointed yesterday to discover that I had matched at my #3 in Medicine, which, for a host of personal reasons, was not as optimal as the first two. #1 might have been a stretch, but I did a rotation at #2 and put a larger investment in my application there.

I don't have any regrets about my list. I'm a lucky guy. When I certified, I was certain that I eventually could get excited about any of my top 3.

The hardest part, I think, was pretending to be happy when I read the letter out loud in front of my class. Your friends know where you want to match. And though the cheers and hugs are the same, you notice that their looks linger on you for a second longer than necessary, as if making sure that the big grin is for real.

 

[mgdsh]

Help- advice- anything. it's all appreciated.

A couple things:
- This is a bit harsh, but honestly, you shouldn't have ranked the program if you didn't want to end up there.
- You should at least give the program a chance seeing that you did match there and you obviously didn't match at your top choices.
- I get the sense that a good portion of your frustration with where you ended up with, is in part due to what you may have to tell others / what others may think.

 

[John Deere Gree]

Rule #1 of being a match participant...Don't get your hopes up based on what anyone says to you.

I think a lot of people get their hopes way up based on what people say to them. I did not rank my top choice based on the feedback I received about my interview and second look visit. This can't be said enough. As a side note, I learned my lesson in med school admissions when one of the interviewers said "I'm impressed with your application. I'm going to do everything I can to get you in here." I was ecstatic thinking I was going to said med school, only to receive a rejection letter a few weeks later.

I have a very nice handwritten letter from my top choice saying how great my interview day was, that I'd be ranked in the top half, blah, blah, blah. I went there for a second visit to further boost my application and was called about a week later by one of the residents stating how there was nothing but high praise for me. After I e-mailed him with a few questions in February (mostly just small talk), I received another phone call from the resident stating that the Rank List was in and that it "looked promising" for me to attend there, with the caveat "but I can't promise you anything." Talk about a huge boost to the ego. But I didn't match there.

I can't fault them for doing anything wrong. Heck, based on their stats they interview about 70 people a year, and I very well could have been in the top 35 (so the PD didn't lie to me). Heck I might have been #9 on their list, but their top eight all chose to go there (so the resident didn't lie to me).

I think it's time to just be happy with where you are at. Sure if I wound up at my 9th or 10th place (last two spots I ranked). My ego would have been bruised, but thankfully I wouldn't have to worry about scrambling. There was a lot of disappointment here on Tuesday. I'm glad I matched. I have a job for the next few years, when many people do not.

One of my close friends (who's a year ahead of me), matched last year at his 11th spot (of 12). Yes he was disappointed, his ego was bruised, and told me over and over how he was not looking forward to being at his residency program in the beginning. However, it has been a wonderful experience for him. He told me that if knew what he knows about the program now, he would have definitely ranked it higher.

Give your residency a chance, and be careful not to burn any bridges early.

 

[Impromptu]

I had spent the last several months convincing myself that I was going to match somewhere else. On match day my name was called near the end, so I got to see the sheer ecstasy of all my friends as they read their #1 choices, they kissed their wives, hosited their kids into the air, and it was generally a great moment for them. I was certain I would have a similar moment (sans the wife and kids), but opened it and found I was going somewhere entirely different.

I wasn't disappointed that I was going to this place, but rather I had already made emotional attachments to the other programs. It took a little while for my brain to make the new adjustment. I found that when I was telling others where I was going, I was rehashing all the good points about the program. I was trying to convince myself that this was a great place.

It worked. I was able to rid myself of those previous emotional attachments and fully embrace my new institution. Now, if NRMP were to email me and tell me there was a mistake, I would be heartbroken, because I've begun making an emotional attachment at the new place.

It is up to me how I feel about a place. It is up to me to take advantage of all situations in which I may find myself.

 

[mig26x]

I can sympathise- i'm in the same boat- totally and completely gutte. Thing is, i'm sort of ashamed-- kinda like a dog when they hang their head low. I'm not even proud of my match- and I can't help but think that THERE MUST HAVE BEEN A MISTAKE!

I can't talk to anyone about this, because well- I've been avoiding all the phone calls and text messages- I guess I'm dissapointed and even a bit embarassed at the outcome. I had huge expectations on myself- bottom line? Perhaps I didn't choose my ROL wisely.

No one really gets how i'm feeling- so I guess I'm looking for moral support.

Concise version? I matched at my #5. When I saw it, I was dumbfounded. All I kept thinking was there must be some sort of error...

My ROL
1) An ultra-ultra competitive specialty--- my only interview in that field- so I figured "all or nothing" I'd be an idiot not to rank them first.

2) Categorical Medicine at Mayo:
- I aced my interviews, i left there beaming-- they contacted me TWICE after my interview asking me to "seriously consider them" and it was just great feedback... I'm absolutely shocked that I didn't match there. I was 90% certain I'd be in Rochester.

3) TY at Henry-Ford:
- yes, yes- I know... TY... It went along with my (#1)- and I honestly love this institution. My thinking was this: If i dont get Mayo (my DREAM!) I might as well use this upcoming year to get practical experience, regroup- and reapply next year. A TY at Ford would have been great at opening doors for me to stay on with them... They offer virtually everything under-the-sun...(fellowship and residency wise) and I don't know, I just loved it.
-* I did NOT receive anyfeedback from them... so I wasn't expecting much.

4) Categorical at Univ. Florida
- Hey, who can argue with good weather and a big university program? Although i wasn't "in-love" there- I found it to be a wise choice.
- opportunities for fellowship abound.
- Again, great feedback from PD post-interview.

5) Categorical at community-university hospital in Chicago.
- Damn. DAMNIT! I honestly didn't think it would come down to this... I was deliberating between this and my #6...
- I chose based on the fact that
a) I was certain I would be in my top 3
b)Chicago is a great city. What a premature decision.
- I'm miserable- I cried all day yesterday. All i kept thinking was, " I worked my a** off for this!?!?!?!?!"
- How did I go from huge institutions with great opportunites for fellowships to this???
- What I hate:
* Only have IM residency (and Path, I think- they might also have rads fellowship)
* NO IM FELLOWSHIPS!!! although they do have good fellowship placement
* IN-TRANSITION: switching over from Northwestern to UC sponsorship
* Facilities (sim-lab, library etc) aren't all that great
* emphasis on outpatient clinic (25% time spend there)
* Didn't get a great idea about didactics and teaching during my visit
BUT... everyone was friendly- residents seemed to have time to have a life outside of the hospital- good camraderie. And Hey- its Chicago.
- I just think that I could have done so much better for myself.

6) Categorical Med @ Banner Good Sam in AZ
- I really liked it here... was confused about placing this and #5.
- They have fellowships (loads) and other residency programs in the hospital
- I listened to my parents nagging about distance: afterall, that would mean relocating to the West-Coast.
- Other hesitatio? Not sure if this means anything- but their program is very DO and FMG heavy.

7) and 8) compare with where I matched.... Community-univ affiliated hospitals... no fellowships BUT they do have other residency programs.

I can't stop thinking about this- it was the last think on my mind last night--- and the first thought this morning. I was half-hoping that yesterday was a dream.

My thoughts are already revolving around:
- how can i get out of this?
- can I call the PD at Mayo and pray for a miracle (visa fall thru etc)
- how difficult is it to transfer? how will that look on my CV (lack of continuity)
- ****!!!! I'm going to be miserable.

This is a time when I should be celebrating my accomplishments- and be beaming with pride. Instead- i'm so bummed. I'm even ashamed. and shocked.

People keep telling me that "there's a reason for everything" - but at this point- I'm so low in my thinking, I can't even see beyond the obvious. The next three months are going to be miserable. and i CANT STOP THINKING ABOUT IT!

Help- advice- anything. it's all appreciated.

My only recommendation for you is: do not type name or location of place you are very dissapointed to have landed because it can make your 1st year a living hell. If the PD or other residents of the program you landed know that you are not very happy to work there it can be a very difficult year. So, please, erase where you landed.

 

[housemd]

He is clearly talking about Evanston Northshore. It is actually a very good hospital with good teaching and quality faculty. Give it a chance, you just might be surprised.

 

[NotAProgDirector]

Concise version? I matched at my #5. When I saw it, I was dumbfounded. All I kept thinking was there must be some sort of error...

I hate to say it, but you basically matched in your #3. Two of your ranks (#1 and #3) were not IM positions. When the NRMP reports that most IM candidates match in their top 3, they're listing 3 IM spots.

What's surprising about your ROL is it's variety. An ultra competitive field, a TY, a univeristy based academic IM program, and then community based programs. If you really wanted to go to a university based / fellowship heavy IM program you should have applied to / ranked more. If you did apply to more and didn't get interviews, then it's not a huge surprise that you didn;t match at Mayo.

Regardless, as others have said, going into your residency with a positive outlook will help, and things are likely to be better than you expect.

 

[Wednesday]

Things happen for a reason. It is very disappointing to match far down on your list, because with so many choices, most people start to imagine themselves at one of their top programs. With all that uncertianty, you have to do something! All those "we're ranking you highly" emails/calls don't help either! And then everyone else seems to get what they want! As someone with a good application who didn't match at the top of my list (a while ago and not in IM) I have to say that it will likely get better. The place I ended up for internship was exactly where I was supposed to be, I just didn't know enough about the program (and the others on my list) to rank it properly. Life comes as it comes, we can't control everything. Best to mourn your loss (venting on SDN is a good outlet) and arrive in July with a smile. Match day will fade. Good luck!

 

[Old_Mil]

It is up to me how I feel about a place. It is up to me to take advantage of all situations in which I may find myself.

...and consider that there's quite an advantage in being somewhere that wants you, instead of somewhere that's just settling for you.

 

[InfraMan]

If your #1 program is a stretch for you, and they don't rank you highly, then you won't match there.

It's very easy to tumble down the list pretty far, just from the mathematics of the match.

Which is why it's important to choose your #1 wisely. And to let them know they are your #1!!!!

 

[peerie]

It's very easy to tumble down the list pretty far, just from the mathematics of the match.

That's pretty interesting, what do you mean by that?

 

[InfraMan]

That's pretty interesting, what do you mean by that?

NEVER MIND - the following advice is wrong as explained in later posts.







I matched at my top choice. After the match, they told me they only had to go down 50 names to get all their residents, out of 150 interviewed.

If I hadn't told them I would rank them #1, and if I hadn't been appropriately competitive, then they would have ranked me below 50 on their list, so I wouldn't have matched there.

Now let's move to my number 2. The match algorithm will work down the residency program's list until they get to me. Let's say I'm #50 on their list. If they haven't filled with people who ranked them #1, (let's say there is one spot left) then the computer temporarily matches me, since I ranked them #2. If the very next person on the program's list ranked them #1, then I get kicked off.

You can see that if your top choices are competitive or they don't rank you highly because they think you won't come there, then you can fall down to a less than desirable residency program where most of the applicants ranked them very low on their lists.

 

[SoCuteMD]

I matched at my top choice. After the match, they told me they only had to go down 50 names to get all their residents, out of 150 interviewed.

If I hadn't told them I would rank them #1, and if I hadn't been appropriately competitive, then they would have ranked me below 50 on their list, so I wouldn't have matched there.

Now let's move to my number 2. The match algorithm will work down the residency program's list until they get to me. Let's say I'm #50 on their list. If they haven't filled with people who ranked them #1, (let's say there is one spot left) then the computer temporarily matches me, since I ranked them #2. If the very next person on the program's list ranked them #1, then I get kicked off.

You can see that if your top choices are competitive or they don't rank you highly because they think you won't come there, then you can fall down to a less than desirable residency program where most of the applicants ranked them very low on their lists.

You've got the algorithm wrong.

 

[dragonfly99]

yeah, inframan doesn't understand the Match algorithm I think.
It's always best for the applicant to rank the programs in the order he wants them. However, showing enthusiasm can influence the program to rank you higher sometimes. The OP didn't apply to enough categorical university IM programs.

 

[InfraMan]

yeah, inframan doesn't understand the Match algorithm I think.
It's always best for the applicant to rank the programs in the order he wants them. However, showing enthusiasm can influence the program to rank you higher sometimes. The OP didn't apply to enough categorical university IM programs.

You're right - I was wrong.

You still need to let your top choice know they are your top choice, though, as you say.

 

[John Deere Gree]

You're right - I was wrong.

You still need to let your top choice know they are your top choice, though, as you say.

I let my top choice know they were my top choice and it didn't help as I matched to my second choice.

...but telling a program they are your number one can't hurt anything, and I would recommend doing so. It may fall on deaf ears, it may not.

 

[InfraMan]

I let my top choice know they were my top choice and it didn't help as I matched to my second choice.

...but telling a program they are your number one can't hurt anything, and I would recommend doing so. It may fall on deaf ears, it may not.

I agree it may work, it may not. It depends on how competitive the applicant is.

But if a program views you as equal to another applicant, and they believe you want to be there, they may rank you higher, because they like to brag that they "only went down x spots" on their list in order to fill.

 

[dragonfly99]

I agree it may work, it may not. It depends on how competitive the applicant is.

But if a program views you as equal to another applicant, and they believe you want to be there, they may rank you higher, because they like to brag that they "only went down x spots" on their list in order to fill.

This is correct. John Deer, you don't know that it didn't help you...it may have helped, but just not enough. NOT telling your #1 they are your #1 can definitely hurt in some cases, b/c if they don't think you want to go there, they may not rank you high enough to get in even if they liked you at the interview.

 

[AnaSedai]

#8 in IM? That really stinks. But this seems to have been a weird Match year all around. I talked with someone in the know at my school, and they said that we had a record number of scramblers this year, with a significant number not getting anywhere at all. And they also said it's probably only going to get worse. I'm sure there will be hard questions asked, particularly since it doesn't reflect well on the school. But it's simple math. The number of medical students is increasing faster than the number of residency slots available to them. Add to that the increasing competitiveness of the IMG's, and we may need to count ourselves fortunate in light of what the future may hold for our younger classmates.

Personally, I matched in my #12 (out of 13). And I was matching into Psych! It's been comforting to read so many people have felt the exact same as me, since I too had good remarks from interviewers, encouragement from program directors, research experience, good board scores, and a personal statement that apparantly impressed many people.

I wanted to match in a combined peds/psych program, but just my luck, there was a much larger, more competitive pool of applicants this year than in years past, and so I ended up matching into a general psych program. It's a good program, make no mistake, but the cognitive dissonance of what I heard and expected, versus what actually happened, has been difficult to deal with. The good news is that I will still be able to become what I want to be, just not in the way I would prefer.

I guess my biggest disappointment is that I won't be in the same city as my boyfriend, who is a year behind me. He's going into pediatrics research, and the peds program where I'm going is not geared toward that career goal. If we're lucky, we'll only be an hour and a half away from each other, but as demonstrated by our experiences here, luck in the match process is a fickle thing.

I'm becoming more philosophical about what happened, and I've been emailing like a madwoman in the hopes of still getting as much peds experience as I can, even without the combined residency. And my boyfriend has done as much as he can to stop me from brooding too much over my dashed expectations.

I figure that if I absolutely have to, I can transfer to the city where he ends up. The place he wants to go for residency has a decent psych program, so there is that option.

On that note, how awkward is it to transfer after a year? Does anyone here know someone that transferred for personal reasons? Will it affect my chances on getting a fellowship? Just wondering. Thanks!

 

[John Deere Gree]

This is correct. John Deer, you don't know that it didn't help you...it may have helped, but just not enough. NOT telling your #1 they are your #1 can definitely hurt in some cases, b/c if they don't think you want to go there, they may not rank you high enough to get in even if they liked you at the interview.

Exactly...It might have boosted me up from 30th to 9th (only to have their top eight match). But who knows. I'll never know where I was on their list, and I am ecstatic at my second choice.

I've talked to a couple of program directors at my school and both have said they take into consideration how likely an applicant will rank them. If they have any hunch that the applicant will rank them low, they will do likewise. Just as we all want our top programs because we like that program, they want applicants who like the program as well.

Bottom line. Tell your number 1 they're number 1.

 

[Colba55o]

I've talked to a couple of program directors at my school and both have said they take into consideration how likely an applicant will rank them. If they have any hunch that the applicant will rank them low, they will do likewise. Just as we all want our top programs because we like that program, they want applicants who like the program as well.

Bottom line. Tell your number 1 they're number 1.

Maybe aProgDir can explain this to me but I don't understand at ALL the concept of moving applicants up on your rank list. Of course, they want people who will like the program. But theres so much more to consider

1) People who like the program will rank it high on THEIR lists. That's what the point of making a rank list is. Is the program worried about getting applicants that will hate it there? If people hate it there then they will rank it low and most likely not match there anyway!

2) By moving up an applicant on their list who tells them that they are their #1 program they are basically moving them ahead of applicants who are likely better qualified in terms of all the other factors that go into the decision. Does this make sense? Also, this is such an incentive to tell many places they are #1 on your list

Now how far up on the list can this actually move you? Of course it won't compensate for low scores/grades. But can it actually move you up far enough to make a difference?

BTW I have been told this by many a prog director. When I ask, I get the same BS answer that "we want people who want to be here". I want to scream "NEWSFLASH, people wont rank you if they don't want to be here. Will the applicant who ranked a program #1 be more productive and a better resident than the one who ranked it #2? Is there ANY evidence to support this?"

I actually think that telling a program that you are their #1 will not move you up on the list at all. I think its a line we get fed because the programs just want to gauge how far down they will probably have to go.

 

[Babycatcher2B]

Maybe aProgDir can explain this to me but I don't understand at ALL the concept of moving applicants up on your rank list. Of course, they want people who will like the program. But theres so much more to consider

1) People who like the program will rank it high on THEIR lists. That's what the point of making a rank list is. Is the program worried about getting applicants that will hate it there? If people hate it there then they will rank it low and most likely not match there anyway!

2) By moving up an applicant on their list who tells them that they are their #1 program they are basically moving them ahead of applicants who are likely better qualified in terms of all the other factors that go into the decision. Does this make sense? Also, this is such an incentive to tell many places they are #1 on your list

Now how far up on the list can this actually move you? Of course it won't compensate for low scores/grades. But can it actually move you up far enough to make a difference?

BTW I have been told this by many a prog director. When I ask, I get the same BS answer that "we want people who want to be here". I want to scream "NEWSFLASH, people wont rank you if they don't want to be here. Will the applicant who ranked a program #1 be more productive and a better resident than the one who ranked it #2? Is there ANY evidence to support this?"

I actually think that telling a program that you are their #1 will not move you up on the list at all. I think its a line we get fed because the programs just want to gauge how far down they will probably have to go.

Colba, I have to disagree with some of the things you have said (as recently went been through the game playing of the match and thankfully match my @ my #1 program.

#1) It is true that if an applicant doesn't like a program that they will likely rank them lower on their list. BUT, there is no guarentee that the programs in which they rank higher will actually rank them high enough on that program's list for that applicant to match there. So it is possible for applicants to end up at places that they do not like because they did not get their higher rank. I have seen it and no everyone in the match gets in their top #3.

#2) I have never been on the program's side of the ranking process so I am not sure if programs will rank less qualified applicants higher just because they are interested. Honestly I think it is not completely true as I know a classmate that did an away at a program, showed interest, got a LOR and ranked at their #3 program. So I'm guessing program's want qualified AND interested applicants. Also, I don't think that there is incentive to tell all programs that they are your #1 but I think it IS an incentive to let all the programs that you are willing to work at that you are indeed interested in their program.

#3) In regards to your statement to PD's that people won't rank you if they don't want to be there. SO NOT TRUE! I ranked all the programs in which I applied including 2 (which I ranked at the bottom of my list) that I didn't really want to train BUT I ranked them b/c I'd rather have a residency spot (and then maybe switch out later) than being without a spot after the scramble. Now I did know some classmates that didn't rank programs b/c they knew they wanted to be in a certain city and they felt really sure that they would get into the few programs they ranked. But that is a personal decision. Also, I had a friend who didn't rank a program b/c she said she would rather scramble than go to that program. All personal decisions.

#4) Actually I believe those applicants who let a program know their INTERESTED not exactly telling them they are #1 may be ranked higher. What if there is an "equally" qualified applicant and you. You let them know your interested in being there, the other applicant doesn't. I'm pretty sure you will get ranked higher.

All of these are my theories and experience as just finishing the match. I welcome other experienced matchers opinions.

 

[drcushing]

I agree it may work, it may not. It depends on how competitive the applicant is.

But if a program views you as equal to another applicant, and they believe you want to be there, they may rank you higher, because they like to brag that they "only went down x spots" on their list in order to fill.

I was under the impression that you cannot say "I would rank you #1" to programs. Sounds like people are doing it anyways. Is there a way to say it without getting into trouble?
Can someone comment on that? thanks.

 

[mcl]

I was under the impression that you cannot say "I would rank you #1" to programs. Sounds like people are doing it anyways. Is there a way to say it without getting into trouble?
Can someone comment on that? thanks.

Applicants and programs can independently tell each other anything they want. What they can't do is negotiate, setting up a quid-pro-quo "I'll rank you number one if you rank me to match*" (or vice-versa) scenario.

*Ranked to match meaning placed on the rank list within the range of a guaranteed match, i.e., if a program has 10 spots, the candidate is guaranteed an ROL spot among those top ten names.

 

[Colba55o]

Colba, I have to disagree with some of the things you have said (as recently went been through the game playing of the match and thankfully match my @ my #1 program.

#1) It is true that if an applicant doesn't like a program that they will likely rank them lower on their list. BUT, there is no guarentee that the programs in which they rank higher will actually rank them high enough on that program's list for that applicant to match there. So it is possible for applicants to end up at places that they do not like because they did not get their higher rank. I have seen it and no everyone in the match gets in their top #3.

#2) I have never been on the program's side of the ranking process so I am not sure if programs will rank less qualified applicants higher just because they are interested. Honestly I think it is not completely true as I know a classmate that did an away at a program, showed interest, got a LOR and ranked at their #3 program. So I'm guessing program's want qualified AND interested applicants. Also, I don't think that there is incentive to tell all programs that they are your #1 but I think it IS an incentive to let all the programs that you are willing to work at that you are indeed interested in their program.

#3) In regards to your statement to PD's that people won't rank you if they don't want to be there. SO NOT TRUE! I ranked all the programs in which I applied including 2 (which I ranked at the bottom of my list) that I didn't really want to train BUT I ranked them b/c I'd rather have a residency spot (and then maybe switch out later) than being without a spot after the scramble. Now I did know some classmates that didn't rank programs b/c they knew they wanted to be in a certain city and they felt really sure that they would get into the few programs they ranked. But that is a personal decision. Also, I had a friend who didn't rank a program b/c she said she would rather scramble than go to that program. All personal decisions.

#4) Actually I believe those applicants who let a program know their INTERESTED not exactly telling them they are #1 may be ranked higher. What if there is an "equally" qualified applicant and you. You let them know your interested in being there, the other applicant doesn't. I'm pretty sure you will get ranked higher.

All of these are my theories and experience as just finishing the match. I welcome other experienced matchers opinions.

I still think that moving applicants up on a programs rank list because they tell them they are #1 goes against the spirit of the match.

If I rank program X #1 and you rank it #2 that doesn't mean that I want to go there MORE than you do, or even that you don't want to go there.
It just means it is where I most prefer to go relative to my list.
But since we have different lists why should I be moved up when I tell the program they are #1?
What if I only got 4 interviews and you got 14? You prefer program X over 12 other prgs while I prefer it over 3 others!
One could almost infer that you are a stronger applicant than me since you got so many great interviews. But I will get the advantage at program X because I ranked them #1.

Who is to say that you DON'T want to go to program X? Who is to say that I would be a better resident there and even happier there just because I ranked it higher than you did?

In response to your statement, applicants should not rank places they DO NOT want to go. Now if you would rather go someplace than be unmatched, then essentially you DO want to go there. How bad do you want to go there compared to other places you are ranking? Thats the point of creating a ROL.

I think if all involved used the match the way it is designed, (soley based on applicant and programs respective preference and NOT on speculation about how bad one really wants the other) then there would be fewer unhappy people and it would make the process more fair.

BTW I didn't tell my #1 that they were number #1 because I wanted to be able to change my mind at the last minute. I told every program I was very interested and would love to join them.
I wound up at my #6.

 

[Babycatcher2B]

Colba,

I totally agree with you on the way the match is done. I also hated playing the game of letting a program know I'm interested in their program, in order to ensure that I wouldn't be ranked lower just because I didn't show interest. And I believe that I was ranked low on my home program's list because I didn't lie to them and tell them the were my #1 and I told them I'd preferred out of state programs. Yes, I really hated it as I feel I was pressured to reveal to them my preferences (which to me is totally against the match). I feel my home program was more concerned about not going very low on their ROL (but that's a different story). I myself told my Top #5 programs that I was interested (mostly b/c of the feeling that if they didn't know I was interested that they would not rank me high). So I actually do agree with, that programs should rank applicants in the order that they would accept them into their program (based on their application and interview) and things might be less stressful for us applicants. CUZ I WAS VERY STRESSED DURING THE RANKING PROCESS! But as you know it is a game, programs are trying to protect themselves from going unfilled and we as applicants are trying to protect ourselves from going unranked. Might I ask, are you happy with your #6 spot and do you feel that you might have matched higher on your list if there were less games being played and less of everyone telling every program they are interested in them (I didn't believe in relieving where I would rank a program, I just told programs what I liked about their program and was still interested in being there even after the interview).

 

[dragonfly99]

colba55o
I think you are right that doing things the way most programs do them (which essentially pressures applicants to compete to show how "interested" they are) does violate the spirit of the Match. You don't understand, though, that programs are doing this because they can and because it's an ego thing for them to be able to say they didn't go down very far on their rank list.

When I was going for cardiology fellowship interviews I had a lot of programs tell me I should "Let them know later if I was very interested". Translation of this @some programs = if we don't hear that we are your #1 we are not going to rank you high enough to match here. When a program has only 3-5 spots, they can pretty much do that to applicants if they want to. Does this induce some applicants to lie? Sure. Is that productive in the grand scheme of things? I don't think so, and neither do you. But the fact is, programs do this, because they don't want to go very far down their rank lists, and they certainly don't want to not fill.

The first year I tried for cards fellowship I had a lot of interviews...a bunch of the places asked me how many interviews I was going on, and where, and several told me to contact them later if I "really wanted to go there". I didn't really understand why they were so interested in where else I was interviewing, and didn't really understand why they seemed so blatantly interested in finding out where I wanted to go (since I myself didn't even know that 2/3 the way through the interview process). I wrote to all of them after the interview, thanking them and telling them the things I liked about the program. For all but one or two (that I really didn't like) I wrote in the letter that I would be very happy to train there, etc. After I did not match, I called back several of the programs, and one blatantly told me that I missed matching by 2-3 spots and that they "didn't really think I wanted to go there" and that if they had known they were at the top of my list that I likely would have matched. This was from the PD. Another program told me I missed matching by a few spots, and that some of the fellows thought I wasn't that interested b/c I didn't go to the preinterview dinner the night before (I could not attend b/c of flying in from a different time zone + having my IM resident clinic the afternoon before, which we were not allowed to cancel for fellowship interviews). I would have been plenty happy to go to the #7 or 8 program on my rank list for cards...but the fact is no cards program wants to take an applicant that ranked them #8...they want the applicant who ranked them #1 and is dying to be there. I think it's silly too, but you and I don't make the rules. I think on the second go-round I really understood how the "game" was played and I played it a little. It worked because I matched at my #1 program. Having said that, I think there was more at play with my not matching the first time than just the interview and ranking/matching process. Realistically, I was a good applicant but I don't doubt there were better applicants, particularly those who were better on paper (i.e. higher USMLE scores, more publications, etc.). If you are applying for any competitive specialty or subspecialty, you had better be ready to pull out all the stops to get yourself a spot, including laying it on thick @interviews (and after) about how bad you want the spot, getting faculty to call on your behalf, etc. etc. It's also kind of like fraternity/sorority rush and people do judge you on superficial things, etc.

 

[peerie]

Well, I am still thinking about the idea that you can 'tumble down' the match list pretty quickly. It seems like you could if say - you put three super competitive programs at the top of your list. Then progressed down from there to about ten.

If you are a good, but maybe average applicant and are not ranked super high by the super competitive programs then you are jumped down right away to maybe your number 4.

If it is a small program (four spots) and several other people put them #1 and you put them #4, it seems that you would then not get that spot - assuming they did rank you highly.

Soooooo ... it SEEMS like that could really happen. I don't really know, just was talking about this with a friend and we couldn't decide. He ended up down his list and wasn't sure how, since at least one program swore up and down they would do anything to have him.

 

[ranmyaku]

If it is a small program (four spots) and several other people put them #1 and you put them #4, it seems that you would then not get that spot - assuming they did rank you highly.

If in your scenario the placed did rank you highly (as in higher than the 'several other people' who put them number 1) then you would get the spot ahead of them, even though you ranked them 4 and 'fell down' your list.


For the people who 'tumble down' a list...the simple fact is that you just were not ranked that highly by as many programs as you thought you were.

 

[Colba55o]

colba55o
I think you are right that doing things the way most programs do them (which essentially pressures applicants to compete to show how "interested" they are) does violate the spirit of the Match. You don't understand, though, that programs are doing this because they can and because it's an ego thing for them to be able to say they didn't go down very far on their rank list.
etc.

I actually do understand why they are doing this. When I stated that I didn't understand why they move people on their lists based on claiming to be their #1 I was more complaining than anything.
I would think that there are other things to brag about besides how far they had to go down on their list. Interestingly, my #6 which is where I matched brags about its 100% written board pass rate. Can my top 5 places say that? Nope, they all come close but not 100%.
It's a shame that programs are that egocentric that they continue to operate this way. It's obvious that with each year the match works less and less like it was intended to as programs try to circumvent the system and pressure applicants to do the same.

To Baby Catcher: I am very happy with where I will be going. It was my 2nd favorite but I got drawn into the hype of name/prestige and ranked the hot shot places highest.
I'm just glad the match is over; at least it didnt cost as much as AMCAS did.,

 

[peerie]

Ok, I see. I just read through the algorithm again and I guess the bottom line is where did the program put the applicant.

This is a really interesting process, and I think Dragonfly's comments are helpful. It's hard to realize that we are supposed to be playing the game - particularly if we don't fully know what the 'rules' are.

 

[dragonfly99]

For the people who 'tumble down' a list...the simple fact is that you just were not ranked that highly by as many programs as you thought you were.

This is correct. Programs are allowed to express a high degree of interest in you, and then still not rank you very high, and they often do. Or maybe they rank you pretty high but get lucky that year and get all the people at the very top of their list...