Understanding How the Match Works is Critical for Succeeding in the Process

Improving written materials and interview skills is important, but all of that work can go to waste if applicants do not understand basic strategies for the Match. This month the NRMP published an article called, "Understanding the Interview and Ranking Behaviors of Unmatched International Medical Students and Graduates in the 2013 Main Residency Match" in the Journal of Graduate Medical Education. The data is especially important for IMGs who represented the majority of unmatched candidates.

Sadly, the authors found that some applicants made strategic errors including the below:

- Not attending all interviews, thus failing to capitalize on every opportunity to market themselves.

- Declining to rank all programs at which they interviewed or not ranking all programs they would be willing to attend.

- Misunderstanding the Match and ranking programs at which applicants did not interview.

- Failing to rank programs based on true preferences or ranking programs based on the perceived likelihood of matching.

It kills me to read about these mistakes :(. Here is a simple explanation of the Match algorithm. If you do not understand how the Match works, it is absolutely critical that you learn about it to avoid destructive errors.

Happiness

The end of the year is a time for reflection and a time to think about what will make you happy in the upcoming year.

When I was a medical student applying for emergency medicine residency programs, a well-meaning dean gave me some bad advice. 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 extremely time-consuming, and you want to be in a city you can enjoy fully when you’re able to blow off steam. 

2. Medical training is extremely 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 (gasp). 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.

Read the Fine Print

A few years ago, a medical school applicant told me the following story:

This pre-med decided to write follow up notes to all the schools at which he had interviewed, usually a good idea. However, he was upset to receive a brusque note from one of the institutions telling him that a) he should have read their policies; they do not allow post-interview contact and b) he was rejected from the school.

I found the school's note pretty severe, and I strongly suspect the post-interview contact was not related to his rejection. (As an aside, he successfully and happily matriculated at another school.) But this story is a reminder that it's important to read institutions' policies about post-interview contact. Most places welcome written updates, but it's essential to confirm before you send.

The LAX Test

How does Google attract the best talent and what does that have to do with medical school and residency training anyway? If you don't have time to read the whole book How Google Works by Eric Schmidt and Jonathan Rosenberg, I strongly recommend this excerpt.

Schmidt and Rosenberg highlight their "secrets" on hiring, including the LAX test, "Googleyness," and hiring folks they may not want to have a beer with. They say the most important skill a business person can develop is interviewing.

In the end they declare, "Nothing is more important than the quality of hiring," which is the ultimate truth for medical admissions as well, of course.