Thursday, January 11, 2007

Rank and Guile

For many of you medical students out there, January 15th marks the birth of a new stage in your career. One that will lead you to hours and hours (and hours) of gratifying time spent in a specialty of your choice. It will signal the beginning of the end of kissing residents’ misshapely asses, scutting for good evaluations, and the education-comes-first mentality. Less than half a year from now, you will actually receive a paycheck, call yourself “Doctor” and you may even live in a different state - all contingent on that RANK LIST. The Rank is a curious creature and many medical students have made crucial mistakes that put them in specialties and/or states that were not for them. Thus, has selflessly created a list of 5 rules for you to remember when constructing your ultimate Rank.

1. More is better. NRMP says: Applicants are advised to rank all of the programs deemed acceptable, i.e., programs where they would be happy to undertake residency training. Get it? If you could picture yourself at a place, put it on your list. And when you are hemming and hawing about whether you really would be happy at County, make sure the alternative you are comparing it with is no-place and it will make your decision a lot easier.

2. More is better. NRMP also says: “Unmatched applicants have shorter lists on the average than matched applicants. Short lists increase the likelihood of being unmatched.” Have we hammered this point home enough? Just in case we haven’t, think of how you’ll feel on Match Day when all of your friends are hugging and kissing and you’re worried about scrambling because you couldn’t picture yourself with all of those residents at County. Get over it and put everywhere you interview on your list!

3. Rank in order of your preference.
This is also straight form The position of a program on your rank order list will not affect your position on the program's rank order list, and therefore will not affect the program's preference for matching with you as compared with any other applicants to the program. Translation: They don’t know where you put them so it cannot affect where they put you. That brings us to another interesting point: Tell every interviewer that they are your number one choice! Act happy to be there and convince them that this really is the place for you with some unique observation about wherever it is that you’re interviewing.

4. Don’t Believe the Hype. Choices should not be influenced by what an interviewer might say to you – positive or negative. One never knows who is interviewing after you and we don’t just mean that they might be smarter and have better USMLE scores. They might be the Chief’s nephew or the daughter of the program director’s secretary, or be high-rankingly hot. Interviewers are human and humans have feelings, wants, needs, likes, dislikes and issues. Thus, take all interviewers’ promises with a large grain of salt and refer to Rule #3.

5. Do your due diligence. First, go to and read how the match algorithm works. Now that you have included all of your possible programs and are stuck on the order of what you like best and least – it’s time to research your options. Find out who the program director and Chairman are; Google the hell out of your department; consider lifestyle aspects like where you’ll live (and for how much); do they publish; so they go on to fellowships; etc etc. You get it now – so get to it and best of luck Ranking your List.

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