Blog Archives

Your Residency Application: Five Factors to Prioritize When Creating your Rank List

Creating your Match rank list can be absolutely agonizing because it feels like so much is at stake. Sometimes it helps to step back and look at the big picture. Below, I briefly note a few important considerations when making your list:

  1. Make sure you understand how the NRMP algorithm works. See my previous blog post regarding errors to avoid at all costs. The key is to rank in the order you want – first goes first, second goes second, etc.
  2. Consider your happiness and life balance. Blasphemy perhaps, but I would argue that they are more important than the strength of the training program.
  3. Reflect on the culture, geography, size, and even maturity/age of the program. Think about whether you will fit in.
  4. Consider whether you could spend your whole life at the institution or in that program’s location. It’s a lot to grapple with, but many residents graduate and stay for the rest of their careers. (Of course, you don’t have to stay post-residency, so if this consideration is too stressful, don’t worry about it.)
  5. Decide whether you liked the program director, chairperson, and faculty generally. They could make or break your happiness and success.
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Check out the NRMP Program Directory for Main Residency Match Applicants

The NRMP® recently launched a directory of residency programs that showcases over 6000 Match-participating PGY-1 and PGY-2 programs. It’s a searchable database that includes locations, program type, and NRMP program codes.

I fiddled with the directory a bit, and I found it most helpful in 1) narrowing down programs by specialty and geography and 2) providing residency director names and program website links.

The NRMP says it will continue to update the database so it remains current.

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How to Evaluate an Institution: Consider Your Happiness and Trust Your Intuition

A few medical school and residency applicants have asked me how to evaluate institutions, especially since interviews are virtual. This is a huge topic, but here are some thoughts:

  • To me, geography is one of the most important factors – at least equal to the reputation of the institution. You want to make sure you are in a location that will make you happy – near community, family, friends and/ or the ability to enjoy your hobbies.
  • Cost is sometimes a deal breaker when it comes to medical school. There’s not much more to say here except that most institutions are extremely expensive.
  • Of course, didactics and academic opportunities are critically important for both medical school and residency. However, many medical schools of similar caliber have equivalent curricula and programs. You likely could be happy at many different medical schools. With regard to residency, it’s important to ensure you are getting a lot of hands-on experience and to look at what fellowships are available, with your interests in mind.
  • Faculty is hard to assess because – like anything – there are good and bad ones. Also, faculty come and go. Having said that, if you are applying to residency, the program director is very important (understanding that he or she could leave).
  • With regard to residency, call schedule and overall work hours are important to consider. Certain programs within the same specialty require a lot more hours and scut work than others.
  • One of your best bets is to talk to current students at medical school or current residents in a training program. Oftentimes they will be very honest about the pros and cons of their institution.

Once you’ve assessed all of the above – narrowing down your list by geography and quality – I would analyze the vibe you have. If this sounds too touchy-feely, remember that intuition is not a magical assessment; it’s based on major and minor facts that you consciously and subconsciously analyze.

Remember: If you’re a medical school applicant, consider yourself fortunate if you have more than one option to choose from. Earning admission to medical school is getting harder every year. It’s a great problem if you need to struggle to decide among multiple schools!

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Responses from Program Directors are as Valuable as the Email They’re Written On

A residency candidate asked me to review an email a program director (PD) had sent him after interview day. The candidate wanted to know if I had any insights into the PD’s intent: Was the PD sending a generic note or was he really interested in the applicant?

I told the applicant honestly: Who knows and who cares?

I wasn’t trying to be dismissive. The point is that it’s impossible to know what a PD is thinking. Unfortunately, I’ve seen applicants heartbroken by false hope they read into a PD’s comments. More importantly, what a PD says should not affect your rank list anyway. The algorithm requires you to put your first choice first and your second second, etc. (More on that in an upcoming January blog post.)

As they say, kisses aren’t contracts and presents aren’t promises. Don’t put deep thought into those PD notes because they don’t guarantee a thing and, as we say in clinical medicine, they don’t change management.

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Your Match Rank Order List Should Be Completely Uncoupled from Institutional Feedback

I’ve recently received some email asking about how Match rank order lists should be affected by positive feedback applicants receive from interviewers and/or program directors. The answer is not at all. Because of the way the Match algorithm works, what programs think of you should have zero bearing on how you make your rank order list. See this recent blog that covers mistakes to avoid when making your list.

It’s really impossible to know about the program’s interest in you anyway. Even if a program tells you straight up that you will be ranked to Match, that isn’t a promise. I’ve known applicants who were “promised” a ranking to Match that never happened. 

Bottom line: It doesn’t matter what the programs think of you; it’s all about what you want. Here’s a good video about the Match algorithm if you’d like to understand the process more granularly. 

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About Dr. Michelle Finkel

Dr. Michelle Finkel

Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more

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