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Being Valued is Undervalued

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I read an interesting JAMA study on burnout recently. We’ve all heard about the problem and its growth over the past few years. But I found the results of this study particularly interesting: The authors found that chaotic workplaces and lack of control of workload were associated with higher burnout (think emergency departments or a poorly run, overscheduled clinic), while efficient teamwork and feeling valued were associated with lower burnout. People sometimes pay lip service to the importance of being appreciated, but this study really proves its significance.

It’s worth considering this study’s results when making decisions about what field to choose, where to train, and what position to take after residency. Here’s the article.

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How to Turn Bad Advice on its Head

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As you get to know different institutions during this interview season, I encourage you to take the opportunity to reflect and consider what will make you happy in the upcoming years.

When I was a medical student applying for emergency medicine residency programs, a well-meaning dean gave me some bad advice: After interviewing at several institutions, I was determining the order of my rank list and was particularly concerned about one program that had an excellent reputation but was in a city I didn’t like. The dean told me, “You’ll be so busy during residency it won’t matter where you live.” Luckily, the advice rubbed me the wrong way, and I wholeheartedly disregarded it. Where you live for your medical training – medical school, residency, or fellowship – is as important as the quality of your training program! The reasons are several-fold:

  1. Medical training is time-consuming, and you want to be in a city you can enjoy fully when you have a few moments to blow off steam.
  2. Medical training is stressful, and you want to be in a city where you have social support.
  3. Medical training is not completed in a vacuum. Your personal life continues. If you’re single you may meet someone and end up staying in the city where you have trained for the rest of your life. If you’re in a long-term relationship you may decide to have children or may already have them. Down the road you may not want to relocate your family.

Not everyone gets the opportunity to go to medical school or train in residency and fellowship programs in a city s/he likes. But you can make choices that will increase your chances. Consider these options – and your happiness – as you make professional decisions this interview season and in the coming year.

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NRMP Match

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Congrats to all those who successfully matched the week before last! The NRMP just published statistics from this year’s Main Match:

Of interest, there were 42,549 applicants who submitted certified rank order lists in this year’s Main Match, and 34,075 of those matched to PGY-1 positions (80.1%). This was a 1.6% increase over last year.

The NRMP also reports that out of 39,205 total positions offered, 36,943 filled (94.2%), and of 36,277 first-year positions offered, 34,075 (93.9%) filled. These rates were similar to last year’s. Of 6,087 total certified programs, 5,367 filled (88.2%), which was a decrease from last year, per the NRMP.

For more numbers, take a look at this NRMP press release.  

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Final Tips for Making Your Match List

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Applicants must have their rank order lists certified by 9 pm EST this Wednesday (March 2). As I’ve mentioned in a previous post, the algorithm for the Match is relatively simple.

The bottom line:

1. Rank programs so they represent your true preferences. Your first choice should be first. Your second should be second and so on. Do not try to “outthink” the system, as it will only be to your disadvantage.

2. Because of the way the Match algorithm works, what programs think of you (or what you think they think of you) should have zero bearing on how you make your rank order list.

3. Except in highly usual situations, rank all programs at which you interviewed. If you would truly rather not match than be at a specific program, then that program should not be on your Match list; however, do think carefully about the prospect of not matching, entering SOAP, and possibly having to reapply next year.

4. Prioritize your happiness.

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Your Residency Application: Six Factors to Prioritize When Creating Your Rank List

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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.

5. Decide whether you liked the program director, chairperson, and faculty generally. They could make or break your happiness and success.

6. Realize that most programs will train you well if you work hard. Their prestige and quality may be more similar than you think. For that reason, note that your personal preferences and intuitions are paramount.

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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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