The Medical School Wait List: Can Anything Be Done?

Just when you’ve completed your medical school interviews and feel that you can sit back and relax because – after all – the rest is out of your hands, you may be surprised by a wait list notification. What is the next step? What can you do?

First of all, realize that getting into medical school has become increasingly competitive year by year. Being wait listed is better than being rejected, and thus a positive, despite the anxiety is causes.

A few things you can do:
1. Send a letter of intent. Let the school know of your continued interest and your new accomplishments. Ensure the letter is well written, streamlined and brief. Be explicit about your enthusiasm, and if the school is your first choice, let the admissions committee know that.
2. Ask the school if you can set up a second look. A second visit indicates to the institution that you are serious, and it offers you more data in making your decision if you are later offered a spot.
3. Do not neglect your other options. Don’t focus all of your attention on this institution to the exclusion of others: Ensure you are well-prepared for upcoming interviews at other medical schools.
4. Plan for last minute notice. At some schools applicants are offered slots off the wait list throughout the summer. I’ve even heard of acceptances being offered the day before medical school was to begin. Would you be able to change your living situation, move your personal belongings and uproot if this were to happen?

Evidence-Based Decision Making Regarding Your Planned Specialty

For those first-, second-, and third-year medical students who are trying to pick a specialty, remember to start with the facts: The NRMP published Charting Outcomes of the Match to give applicants an idea of what characteristics successful 2014 Main Residency Match candidates had. While sobering (the mean Step 2 score for successful radiology U.S. senior applicants was 249), the information is valuable as you approach the decision-making process.

If you're early in the process, you can strategically plan your candidacy for success. If you're later in the process, you can decide whether you have the characteristics necessary to pursue a successful Match process.

Doctor, Shut Up and Listen

This recent NYT piece by Nirmal Joshi is interesting, and as someone with a human biology background, I'm a big fan of improving patient-doctor communication.

But the author fails to address a critical factor here - oppressive patient volumes. In the Emergency Department (ED), a physician must balance the time she's spending with each patient with the wait time that many others are suffering without having had the privilege of seeing a doctor yet. And crushing patient volume is not just an ED problem. A primary care friend of mine told me she has to see one patient every 15 minutes to keep on schedule. She points out that just getting a thorough history from a new, elderly patient and counseling on preventive care can take all of that time.

Match Ranking may be emotionally hard, but it's strategically easy

For those of you who are starting to think about your Match rank lists, please remember that you simply rank your first choice first, your second second, etc. The Match algorithm is mathematically quite complicated, but because the process always begins with an attempt to match an applicant to the program most preferred on the applicant's rank list, your best bet is not to try to "game" the system.

For example, I've had applicants tell me that they plan to rank a less preferred institution higher because that program has more residency slots. That's a no-no. The applicant will actually be harming him/herself with that strategy.

Here's some information from the NRMP regarding the Match algorithm. Here's also a less-than-one-minute Guru on the Go© video "NRMP Ranking to Avoid a Spanking" to emphasize your optimal ranking strategy.