Where are the interviews?

This is an update to last years post on the same topic.  The mismatch appears to be worsening between the number of programs applied to AND the number that an applicant needs to apply to...

This is an anxiety provoking time of year for both sides in the EM residency match process.  Most residency programs start interviews by early November, and they are worried that in the increased numbers of applications they are receiving, they are not going to invite the right applicants to fill their classes.  But right now, we are not worried about the residencies. They are going to be fine.

As an applicant for EM residency you find yourself in one of two groups:

• Group A:  The Fortunate Few - You have too many interviews (more than 10 - 12) and you are not sure which ones you are going to actually do.  You may even have 15 or more and think that you are going to want to do that many.  
• Group B:  Everybody Else - You don't have enough interviews (less than 10-12) and you are in a panic over having to scramble to another specialty.

Let's deal with Group A first, as the name suggests, theirs are good problems to have.  Unless you have special circumstances, like a difficult couples match (EM-ortho, EM-EM, EM-Derm), at 10 to 12 offers, you already have all the interviews you will need.  And as programs start to get into their Wait Lists, you are going to get MORE offers.  In your Personal Statement you talked about what a great team player you are, now is your chance to prove it.  Politely decline some of those interview offers. Throw them back.  As programs higher on your list contact you with an opening, let another one go.  Most people do not want to do more than 10 - 12 interviews.  No one has stayed sane doing 20.  You will match 95% of the time if you rank 10 or more programs.  If you look at the graph below (from the NRMP's Charting Outcomes from the 2014 Match), having a number of interviews beyond 8 - 10 does not really prevent someone from not matching.  There is a no 100% guaranteed number.  If the quality of your interviews are poor, it does not matter how many you do.

If you are in Group B, you are nodding vigorously right now.  You are waiting for interview offers because your colleagues are holding on to ALL of the interview spots.  They will start to give some of them back.  More spots will become available.  What you need to do right now is make sure that when those spots open up, you get consideration for them.

Make sure your application is complete.  If a letter was not uploaded, many programs will not have even reviewed your application before giving out all of their interview spots.  If your application was completed late (i.e. a SLOE came in late), send a polite email or call the contact person of your most important programs.  Showing a little extra interest, COURTEOUSLY, can make the difference in who on the Wait List gets offered an interview.  This is the most useful thing you can do to increase your interview chances.

Don't waste your time and money applying to more EM programs.  This seems tempting, but it will not help.  The programs will know that you just applied to them.  Most EM programs have the luxury of being picky about who they interview.  They are not going to be interested in looking at the application of someone who only recently became interested in them.  Not when they already had hundreds of more enthusiastic applicants.  And they have already offered most of their interviews and created a Wait List.

Open up your January.  Interviews opportunities are going to become available, especially in January. Applicants with a lot of interviews in November and December will realize they are good and will cancel January interviews.  You may get short notice offers to come interview and you want to be ready to respond.  You may have had your heart set on that Beach Medicine elective in May, but you are better off moving whatever you are doing in January to a later block.

Polite interaction with programs that already have your application is your best bet.  Be available on short notice.  Be courteous with whoever you get in touch with.  Be ready to bring your A-game on the interviews you get.  It only takes one program to rank you competitively to get you into EM.

Adam Kellogg is an Associate Residency Director and former Emergency Medicine Clerkship Director.  He thoroughly enjoys polite emails that provide new information about a residency applicant.