The Rank Order List Deadline Is Approaching: Check Yourself Before You Wreck Yourself

This is an important reminder that Wednesday, February 20 at 9pm EST is the rank order list certification deadline. Start now to think about your priorities and specifically, where you will be happiest. Waiting until the last minute and making impulsive changes to your list is not a great idea.

Please make sure to avoid simple missteps in creating your rank order list. Improving written materials and interview skills is important, but all of that work can go down the drain if applicants do not understand basic strategies for the Match. In November of 2015 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.

Here is an 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.

Do No Harm

I recommend reading this piece in Emergency Medicine News by Dr. Graham Walker. He writes about a physician colleague who recently committed suicide. The article notes that anesthesiologists and surgeons are the most likely to die by suicide, and emergency physicians come next in the specialties. 

As a follow up, this NYT piece on physician suicide is also worth a read - old but still relevant. Sadly, it notes that pre-meds enter medical training with mental health profiles similar to those of their peers but end up experiencing depression at greater rates.

I've written about depression in doctors before and would like to reinforce the importance and urgency of seeking professional help for depressed clinicians.  

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 2018 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 just starting medical school, you can strategically plan your candidacy for success. If you're more senior, you can decide whether you have the characteristics necessary to pursue a successful Match process.

The “No Contact” Rule After Interviews

Just a brief reminder about the “no contact” rule that some residency programs (and medical schools) follow. While thank you notes and letters of interest are often warranted, if the institution requests no contact, it is important that you follow that rule. First, you don’t want to be seen as someone who is trying to gain an advantage when others are holding back, and second, you would like to be viewed as a candidate and future practicing physician who notes and follows instructions.

Importantly, if you are contacted by residency programs after your interview and promised a ranking to Match, I’d suggest you take that information with a grain of salt. It is flattering, but it should not change your Match list in any way. If a medical school contacts you with a positive review but no acceptance (yet), I would suggest being gracious while you continue to move through the admissions process. In other words, don’t let compliments affect your good judgment.