Applicants must have their rank order lists certified by 9 pm EST this Wednesday (March 2). As I’ve mentioned in a previous post, the algorithm for the Match is relatively simple.
The bottom line:
1. Rank programs so they represent your true preferences. Your first choice should be first. Your second should be second and so on. Do not try to “outthink” the system, as it will only be to your disadvantage.
2. Because of the way the Match algorithm works, what programs think of you (or what you think they think of you) should have zero bearing on how you make your rank order list.
3. Except in highly usual situations, rank all programs at which you interviewed. If you would truly rather not match than be at a specific program, then that program should not be on your Match list; however, do think carefully about the prospect of not matching, entering SOAP, and possibly having to reapply next year.
The Medscape National Physician Burnout & Suicide Report 2021 is now available, and it seems rather evident that the pandemic has negatively affected physicians who were already under a lot of stress, especially those in critical care medicine.
More than half of critical care physicians report being burned out (51%), and critical care ranks as the highest specialty in the burnout questionnaire, followed by rheumatology (50%) and infectious disease (49%). Those numbers compare with last year’s report at 44%, 46%, and 45%, respectively. This year, my field of emergency medicine (EM) was at 44%, which sounds high, but, sadly, EM was not even in the top ten burned out specialties. That gives you an idea of the severe scope of the problem.
Women reported burnout at 51% compared to 36% for men, and while this disparity has been present for many years, the discrepancy between the genders was greater in this most recent report.
Seventy-nine percent of those surveyed relayed that their burnout started before COVID, while 21% reported after. Bureaucratic tasks and too many hours at work were the major reported contributors to burnout.
Several years ago I was hired by a re-applicant who wanted to better understand why she did not get into medical school the prior year. She had a 3.9 GPA and a 40 on her MCAT (100% percentile). Yet, she had been rejected from all medical schools.
I looked through her materials and discovered the problem. The applicant had no clinical work at all. She had never been in the room with a patient. Many of you know that I like the saying, “No one wants to hire a chef who hasn’t been in the kitchen.” She had fallen prey to that adage.
We talked, and I advised her regarding options she had for obtaining clinical experience. Fast forward a year: The client completed a robust clinical activity and was readily accepted to medical school (and felt more confident about her career choice).
If you are a pre-med, note that robust clinical experience is critical. Working as an EMT, in a good clinical care extender program, formally as a scribe (where you can also make some money), in a hospice setting, or in a low-income clinic are just some ideas for obtaining excellent clinical exposure. (Although you might think free clinics would be thrilled to have a pre-med volunteer, many understandably require one-year commitments.)
Shadowing is a mixed bag: Medical schools don’t know whether you’re second-assisting in the operating room or just standing in a corner being ignored. If you choose to shadow, make sure that – in your written materials – you highlight any substantive clinical skills gained. Other popular options for clinical experience include international work (although the activity is usually short-lived, which makes it less robust) and working as a volunteer in a hospital (although it might be more clerical than clinical, depending on the position; thus, the benefit of clinical care extender programs. Do your research before accepting a volunteer hospital job). I’ve also had advisees who became certified, practicing phlebotomists and others who worked in veterinarians’ offices to obtain procedural skills.
More important than getting into medical school (gasp), getting robust clinical experience will help you ensure you’ve made the right career choice. Simultaneously, you’ll demonstrate to admissions officers that you can handle the heat.
See the short video below on the importance of clinical experience:
Creating your Match rank list can be absolutely agonizing because it feels like so much is at stake. Sometimes it helps to step back and look at the big picture. Below, I briefly note a few important considerations when making your list:
1. Make sure you understand how the NRMP algorithm works. See my previous blog post regarding errors to avoid at all costs. The key is to rank in the order you want – first goes first, second goes second, etc.
2. Consider your happiness and life balance. Blasphemy perhaps, but I would argue that they are more important than the strength of the training program.
3. Reflect on the culture, geography, size, and even maturity/age of the program. Think about whether you will fit in.
4. Consider whether you could spend your whole life at the institution or in that program’s location. It’s a lot to grapple with, but many residents graduate and stay for the rest of their careers.
5. Decide whether you liked the program director, chairperson, and faculty generally. They could make or break your happiness and success.
6. Realize that most programs will train you well if you work hard. Their prestige and quality may be more similar than you think. For that reason, note that your personal preferences and intuitions are paramount.
For those of you who are starting to think about your Match rank order list, please make sure you follow this simple strategy: Rank your first choice first, your second second, your third third, etc.
In other words, your most successful approach is to create your list in order of your real preferences. Although the Match algorithm is mathematically quite complicated, because the process always begins with an attempt to match an applicant to the program most preferred on the applicant’s list, you do not want 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.
Dr.Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to
stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital.
She was appointed to the Assistant Residency Director position for the Harvard Affiliated
Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more
