Sunday, January 13, 2019

The Making of a Rank List



As interview season comes to an end it is time to think about what you need and want, and begin putting your rank order list together. First make sure you know the process and important dates. This year the Rank Order List Certification Deadline is FEB 20 at 9pm ET. Go over how to input your rank order list into R3(NRMP Registration, Ranking, and Results).

In recent years we have covered composing your rank list in great detail, go ahead and review the data and approaches you can take. This was written by Tony Zhang, an Emergency Medicine Education Fellow and member of the CORD Advising Student Committee in EM. A version of this guide is part of the CORD SATF Applying Guide to Emergency Medicine.

Last year EMRA published something similar using a survey of residents training in Emergency Medicine and drawing themes from those responses. They do a nice job showing the variety of different viewpoints and approaches that can be taken in creating a Rank List.

No two people approach their rank list the same way for good reason. This is all about you and your best fit. Many of you are starting to second guess your top programs. This is normal. Everybody does this. You hear from friends, advisors, and deans, and they all have different opinions on where you should go. Remember to focus on what YOU want, above all else.

Think about the top 3-4 programs on your list. Picture them in your mind and see which one causes the biggest smile to split across your face. That is your number one. Stop perseverating - that is YOUR number one. 

When deciding the order of the next few programs, continue to follow your heart. The Match is student weighted, so you get preference. The order you rank the programs matters. You want your list to reflect your true desire to train at the program. Put the spreadsheet down, stop talking to everyone, and focus on how you feel overall about each program. Above that, these are the common pitfalls to avoid:

Squirrel - Being distracted by shiny objects 
Many of the superficial attributes of a program are not going to determine if you are satisfied with your experience training there. You will spend the bulk of your time in the ED, focus on how that learning environment will work for you. 

Location is really important for most people. Though being in a location that others think is cool, but you don’t see yourself in, shouldn’t count as an asset. 

Glossing over glaring negatives
There are only a few things in a program that will have an enormous impact on your training experience:
Program Director - If you didn’t click with the PD- think hard before ranking this program highly. This is not a person you can avoid.
Residents - If they weren’t really happy, or you don’t see yourself as a part of their group, this is not the program for you.
Curriculum - ensure the educational approach, the design of the rotations, and the responsibilities on shifts match up with your needs.

Being Flattered by attention
Be careful to not allow a program’s perceived response to you influence your ranking. Many programs purposefully withhold telling students how well they were liked, while others may overestimate where you are on their rank list. This is a time to trust yourself and be wary of being influenced.

In the end you need to trust your gut, rank your programs in the order you want to be there. Keep in mind more than half of you will get your top choice, and 80% will get in your top 3. You have the control. Use it wisely.



2 comments:

  1. As a DO in the 4th quartile I just don't see my top 4 programs ranking me in the top 50 of the rank list (assuming class size of 12 that goes down about 4.5 per spot to fill).... man will I work my bottom off in residency tho!

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  2. Anonymous,
    Your math is correct and sounds daunting, but remember there are lies, damn lies and statistics. You got interviews and once you are at them they focus on you as a person. If they saw you as a great fit your class rank shouldn't move you out of matching. I know it is tempting to re-order your list trying to decipher where you will be ranked more highly - don't do it. This is a classic blunder that can cause you to go unmatched. The match program will keep placing you in your best rank moving you down and off by the programs list. If you rank programs in order of preference you will get your highest possible match. If you try to guess so you are higher on their list you loose the chance at the spots you loved and you might be wrong and do even worse.
    Stay calm and rank on
    Cien

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