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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Introducing NRMP’s Rank Order List Lock Pilot

In October I wrote a blog entry about the benefits of virtual interviews. One issue that has come up is the concern that those who choose to do in-person interviews may have an advantage compared to candidates who interview virtually. The NRMP has noted this worry and is, consequently, instituting a voluntary Program Rank Order List Lock pilot for internal medicine, pediatrics, and vascular surgery for the 2026 Main Residency Match cycle.

The idea is that programs can choose to finalize their certified Rank Order Lists and then provide time for interviewed applicants to come in-person, thus reassuring candidates that visiting or not visiting will not affect their candidacies.

Here is a statement from NRMP regarding the voluntary pilot. It’s an interesting idea, and I’m curious to see how it will play out.

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Match Week Starts Next Monday

Monday, March 15 starts Match Week 2021. For a comprehensive review of events, see the calendar here. Of note, SOAP starts at 11am EST and ends on March 18 at 3pm EST. On Friday, March 19 at noon EST, applicant Match results are available.

SOAP is somewhat complicated, so if you have questions about the process, make sure you read about it.

I’m wishing everyone good luck in the Match. If you are a current residency client, please email me with your results!

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Crossing Fingers for a Happier 2021

Medical school and residency training usually decrease one’s happiness for several reasons: Happiness researchers have demonstrated that a feeling of control and the amount of spare time one has both correlate with happiness. Both of those factors are limited during med school and residency. Relationships are also correlated with happiness, and those can be squashed during medical training as well.

Especially considering how difficult 2020 has been, I want to encourage applicants to consider this happiness quotient when selecting an institution and training program. If you are able, maximizing your contentment by choosing an institution that fosters your greatest happiness is key. Geography; proximity to family, friends and community; and a location that provides an opportunity to enjoy hobbies during limited free time is significant.

Excellent training is important, but, in the end, many medical schools and residency programs turn out equally qualified clinicians. Prioritize your well-being as a factor in selecting where you might be for the next several years of your life.

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The Week I Spent 138 Hours in the Hospital

During my internship, on my surgical rotation, I once spent 138 hours in the hospital in one week. If you think this isn’t mathematically possible, I will tell you that I was on call from Monday morning to Tuesday evening, from Wednesday morning to Thursday evening, in-house on Friday, and then on call from Saturday morning until the next Monday morning. (I had to stay in-house that Monday until evening rounds were over too.) As you can imagine, I was barely human by the end. How this schedule was good for patient care is beyond me.

I thought of that ghastly time recently when reading this article in the New York Times called “How Job Stress Can Age Us” written by Dr. Dhruv Khullar. The author reports on a study, “Physician-Training Stress and Accelerated Cellular Aging” that assessed the DNA of 250 first-year medical residents around the country. Researchers examined the saliva samples of these residents, focusing on their telomeres – the bumpers at chromosome ends that prevent DNA damage – before and after the first year of residency. Researchers found that the DNA of first-year residents aged six times faster than normal.

Six times faster.

I found this both shocking, upsetting, and validating. Residency training is as hard as we think it is. 

What I would strongly recommend is that you compare residency programs’ hours before you create your Match list. Strangely, many applicants don’t even consider this important issue when making decisions about their next three to five years. Also, many residencies support physician wellness programs and night coverage. Especially in the setting of severe burnout among doctors, your happiness should be a primary factor in your career choices. If you’re not sure, consider your shrinking telomeres. 

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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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