Residency ranking games

[Adamdoesntlikecoffee]

So I just found I matched to a fairly competitive non-surgical specialty, not to my top choice program though.

During the ranking process I had a few phone calls and emails from several programs strongly hinting I would be ranked highly with one PD actually telling me outright that I was their top ranked applicant

As a result I ranked those places as my top choices. Yesterday I found out I didnt match to ANY of the places that had reached out to me. I'm thrilled to have matched but MAN, feels like a hurricane in my head with these mind games.

Anybody have a similar experience? Do programs get more funding or something if they get more applicants that rank them as their first choice ? LOL 

 

 

[1D7]

31 minutes ago, Adamdoesntlikecoffee said:

As a result I ranked those places as my top choices.

Hahahaha why??? Them liking you should have no effect on how you rank the programs.

In my experience a lot of applicants misinterpret nice emails and phrases. "You are a strong/great/top/wonderful/excellent/exceptional applicant" = you could be anywhere between 0-100th percentile of ranked applicants on their list.

Quote

Anybody have a similar experience?

Yes but I didn't let it affect my rank decision one bit. If I received something like that, the only assumption I made was that I was at least probably ranked somewhere on the list.

An an applicant I was used to saying how every program was a great choice, wonderful place to live, etc. It wasn't completely untrue, since on my entire rank list even the most middle-of-nowhere programs in my specialty I ranked higher than the dozen of FM programs I had ranked as well. Thus when I would read/hear programs telling me those sort of things, I could tell they were just being nice.

But let's say that they were being genuine. Why would that at all change how you rank them?

Quote

Do programs get more funding or something if they get more applicants that rank them as their first choice ?

The system favours the applicant, so programs will do their best to try and make sure they don't have unmatched spots.

[rmorelan]

45 minutes ago, Adamdoesntlikecoffee said:

So I just found I matched to a fairly competitive non-surgical specialty, not to my top choice program though.

During the ranking process I had a few phone calls and emails from several programs strongly hinting I would be ranked highly with one PD actually telling me outright that I was their top ranked applicant

As a result I ranked those places as my top choices. Yesterday I found out I didnt match to ANY of the places that had reached out to me. I'm thrilled to have matched but MAN, feels like a hurricane in my head with these mind games.

Anybody have a similar experience? Do programs get more funding or something if they get more applicants that rank them as their first choice ? LOL 

 

 

so they basically lied............yeah that can happen. There is a lot of pressure on the programs not to be unmatched (the pressure is NOT all on the med students here - a PD that doesn't match good people is going to hear about it for ages. Plus usually PDs are relatively junior staff - so set backs hurt more. Get a bad resident and you stuck with them for 2-5 YEARS). They don't get more money etc - but the PD saves face, and they don't have to go through all the extra work of filling spots in the second round (which is a mess). It is way better for them to just fill things up in round 1 and move on with life. 

The advice here is simple but yes hard to actually do in face of all the distractions - and everyone has already heard it. Rank always and every time in the order of your preferences. What the schools are doing is completely irrelevant. It really doesn't matter. Doesn't matter if they want you - it matters that you want them.....period. 

[hopeful_med]

1 hour ago, Adamdoesntlikecoffee said:

So I just found I matched to a fairly competitive non-surgical specialty, not to my top choice program though.

During the ranking process I had a few phone calls and emails from several programs strongly hinting I would be ranked highly with one PD actually telling me outright that I was their top ranked applicant

As a result I ranked those places as my top choices. Yesterday I found out I didnt match to ANY of the places that had reached out to me. I'm thrilled to have matched but MAN, feels like a hurricane in my head with these mind games.

Anybody have a similar experience? Do programs get more funding or something if they get more applicants that rank them as their first choice ? LOL 

 

 

I don't know why candidates get confused about this. YOU ALWAYS RANK BY YOUR PREFERENCES BECAUSE CARMS FAVOR THE CANDIDATE OVER THE PROGRAM. People need to stop over thinking and over analyzing

[garlic]

2 hours ago, rmorelan said:

so they basically lied............yeah that can happen. There is a lot of pressure on the programs not to be unmatched (the pressure is NOT all on the med students here - a PD that doesn't match good people is going to hear about it for ages. Plus usually PDs are relatively junior staff - so set backs hurt more. Get a bad resident and you stuck with them for 2-5 YEARS). They don't get more money etc - but the PD saves face, and they don't have to go through all the extra work of filling spots in the second round (which is a mess). It is way better for them to just fill things up in round 1 and move on with life. 

The advice here is simple but yes hard to actually do in face of all the distractions - and everyone has already heard it. Rank always and every time in the order of your preferences. What the schools are doing is completely irrelevant. It really doesn't matter. Doesn't matter if they want you - it matters that you want them.....period. 

As an aside, how do programs feel when they match students who are lower on their list? Do they readjust and get excited regardless, or is there a sense of disappointment that lingers

Maybe I'm projecting here, but my matched program was known to have a lot of students from their med school aiming for the specialty. But the >70% of those who matched to my program were not from their med school. Of course theres no way of knowing what happened but it strikes me as a bit odd

[1D7]

6 minutes ago, garlic said:

As an aside, how do programs feel when they match students who are lower on their list? Do they readjust and get excited regardless, or is there a sense of disappointment that lingers

Maybe I'm projecting here, but my matched program was known to have a lot of students from their med school aiming for the specialty. But the >70% of those who matched to my program were not from their med school. Of course theres no way of knowing what happened but it strikes me as a bit odd

It could be that the program wanted those from other schools. Tbh there's no real way to know unless you were a part of the ranking process or it is extremely obvious somehow.

[hopeful_med]

Also as a side and a disclaimer. I have gone through 2 CaRMS cycle after my own match, and it seems that the rank list is a confidential thing that even the people who participated in the selection process is not privy to. So how did OP know that he/she was not ranked at their preferred program? Maybe he/she was just ranked low?

[rmorelan]

11 minutes ago, garlic said:

As an aside, how do programs feel when they match students who are lower on their list? Do they readjust and get excited regardless, or is there a sense of disappointment that lingers

Maybe I'm projecting here, but my matched program was known to have a lot of students from their med school aiming for the specialty. But the >70% of those who matched to my program were not from their med school. Of course theres no way of knowing what happened but it strikes me as a bit odd

Ha I think it is usually like it would be for applicants not getting their top choices but still matching to their chosen area. It has always look similar on both sides - and relatively quickly people forget the rankings etc and just get on with the day to day. 

[rmorelan]

1 hour ago, hopeful_med said:

Also as a side and a disclaimer. I have gone through 2 CaRMS cycle after my own match, and it seems that the rank list is a confidential thing that even the people who participated in the selection process is not privy to. So how did OP know that he/she was not ranked at their preferred program? Maybe he/she was just ranked low?

unfilled spots usually in the area they ranked.

Edited March 5, 2020 by rmorelan

[hopeful_med]

1 hour ago, rmorelan said:

unfilled spots usually in the area they ranked.

I am just confused. If programs are so concerned about not filling their spots and so are "lying" to candidates such as OP.... why are they not ranking everyone? 

Edited March 5, 2020 by rmorelan

[rmorelan]

1 minute ago, hopeful_med said:

I am just confused. If programs are so concerned about not filling their spots and so are "lying" to candidates such as OP.... why are they not ranking everyone? 

that is a bit confusing ha - sometimes there is a branch of the CARMS team that just encourages everyone to rank them highly regardless, and other branches that create their actual rank list - the two teams don't have to be moving at the same speed. 

like all bureaucratic systems they can be inefficient.  

[1D7]

20 hours ago, hopeful_med said:

I am just confused. If programs are so concerned about not filling their spots and so are "lying" to candidates such as OP....

Unless the program explicitly said "OP you are our #1 candidate" or something along those lines then I don't see it as a lie. It's just social etiquette that we all have to play along with; no different than how we talked to our 'back up programs' during interviews.

Of course I don't think this behaviour should be encouraged, but frankly applicants should realize that there is no reason to change their rank decisions based on someone telling you they like you.

Quote

why are they not ranking everyone?

Programs objectives: #1 Fill all spots with adequate candidates #2 Avoid all potential trouble residents

Every program has had or has heard of a horror story of a resident and will do their best to avoid such a situation. For extremely small specialties (e.g.1 residents/year) this becomes exponentially more important since the loss of 1 resident in a year is a loss of 1/5th of all your residents & call pool. Programs do not have much to go on for applicants outside of direct interaction during electives, thus even the potential for a significant deficiency/red flag may lead to a program not ranking you (e.g. going through CaRMS a 2nd time, failure on MSPR, terrible interview, unprofessional interactions during socials, poor elective performance, likely desire to switch out, etc.).

 

[bearded frog]

Anecdotally, I've heard our program only ranks candidates that would be a good fit, any doesn't rank anyone they possibly wouldn't want to work with, even if it leaves us with empty spots. As competitiveness increases, there is a large pool of qualified unmatched applicants/IMGs in the second round that might be a better fit.

[rmorelan]

38 minutes ago, bearded frog said:

Anecdotally, I've heard our program only ranks candidates that would be a good fit, any doesn't rank anyone they possibly wouldn't want to work with, even if it leaves us with empty spots. As competitiveness increases, there is a large pool of qualified unmatched applicants/IMGs in the second round that might be a better fit.

which makes sense - I cannot tell you how much worse it is for a program to have a bad resident than no resident at all. That would be the equivalent for a program to a med student matching to a specialty they didn't want and well hate - as hard as it is it would still be better most often to go unmatched than set yourself up for a career you cannot stand.. 

[jnuts]

Yes, there is a prestige thing within the program of getting your top ranked applicants.  There's a gentle pressure sometimes to not rank applicants highly who the program suspects may not rank the program highly and go somewhere else.  It's silly and of no consequence to the program other than egotism, but it has come up in committee deliberations about the rank list.

[Cheers2life]

10 minutes ago, jnuts said:

Yes, there is a prestige thing within the program of getting your top ranked applicants.  There's a gentle pressure sometimes to not rank applicants highly who the program suspects may not rank the program highly and go somewhere else.  It's silly and of no consequence to the program other than egotism, but it has come up in committee deliberations about the rank list.

Have you ever heard of programs not even inviting candidates to interviews because they thought they would most likely match in another speciality?...

[jnuts]

22 minutes ago, Cheers2life said:

Have you ever heard of programs not even inviting candidates to interviews because they thought they would most likely match in another speciality?...

No question yes.  Interview day is a big burden on programs and staff. There is always talk about minimizing the number of interviewees to the smallest possible number to fill spots (and hopefully not have to do it all again for R2).

Significant interests outside the specialty are a red flag that can not get you an invite.

[insomnias]

11 minutes ago, jnuts said:

No question yes.  Interview day is a big burden on programs and staff. There is always talk about minimizing the number of interviewees to the smallest possible number to fill spots (and hopefully not have to do it all again for R2).

Significant interests outside the specialty are a red flag that can not get you an invite.

Attendings: "The purpose of med school is to become a good generalist! You should seek a broad diversity of electives!"
Also attendings: "This student doesn't seem committed enough to this specialty. Let's not interview/rank them."

[jnuts]

2 minutes ago, insomnias said:

Attendings: "The purpose of med school is to become a good generalist! You should seek a broad diversity of electives!"
Also attendings: "This student doesn't seem committed enough to this specialty. Let's not interview/rank them."

Agreed.  Except remember they're two different people. The PD usually doesnt know or care what the undergrad director/coordinator is doing or saying.

At the med school level they also want to make sure you've got a back-up--for the preservation of their own scores and outcomes.

[Lactic Folly]

14 minutes ago, insomnias said:

Attendings: "The purpose of med school is to become a good generalist! You should seek a broad diversity of electives!"
Also attendings: "This student doesn't seem committed enough to this specialty. Let's not interview/rank them."

We aren't talking about students who have a broad diversity of electives. We are talking about students who have 8 weeks in another competitive specialty, so that it raises the legitimate question of whether the application is a backup.

[jnuts]

21 hours ago, Lactic Folly said:

We aren't talking about students who have a broad diversity of electives. We are talking about students who have 8 weeks in another competitive specialty, so that it raises the legitimate question of whether the application is a backup.

Fair.  I think there's a spectrum between those extremes where things get subjective and applicants struggle to predict how it's going to look to programs.

To applicants you can also demonstrate evolving interests if your later electives are all in a target specialty despite a seemingly split application.

 

[Cheers2life]

i meant skipping a good candidate that has a fairly good background for their specialty over the fact that they think this candidate might actually have a better shot elsewhere...not because the program feels they're one's backup...as if they we're thinking: there's no point of interviewing him cause he will most likely match do another competitive specialty.

[Lactic Folly]

1 hour ago, Cheers2life said:

i meant skipping a good candidate that has a fairly good background for their specialty over the fact that they think this candidate might actually have a better shot elsewhere...not because the program feels they're one's backup...as if they we're thinking: there's no point of interviewing him cause he will most likely match do another competitive specialty.

This would have to be an uncompetitive program that is historically never picked by strong candidates.

[Redpill]

On 3/8/2020 at 11:11 AM, jnuts said:

No question yes.  Interview day is a big burden on programs and staff. There is always talk about minimizing the number of interviewees to the smallest possible number to fill spots (and hopefully not have to do it all again for R2).

Significant interests outside the specialty are a red flag that can not get you an invite.

Would this also be the case if the other interest was Family Medicine as an obvious "parallel plan"?

[jnuts]

16 hours ago, Redpill said:

Would this also be the case if the other interest was Family Medicine as an obvious "parallel plan"?

Good question.  I think it would come down to how serious they thought your interest was.