Ranking pprograms Dos and DONTs

NRMP opens rank order list to applicants in mid-January. You have to rank the programs in an order of preference. The list closes on the last day of February. In spite of matching algorithm sounding somewhat out of science fiction movie, it really is pretty straightforward. It uses ranking order lists (both programs and applicants) to find the best match between the two. All you have to do is to rank the programs the way you like them. Use your Program Evaluation Worksheet, which we sent you earlier in the season) to refresh your memories. If you rank a less competitive program low on the list, this does not decrease your chances of matching with this program in case if you did not match with any program above it in the list. A more complicated subject is supplemental rank order lists, which are used to rank advanced specialty programs. Again, you should not worry about the chances, just rank your main list as well as supplemental lists in the order of preference. Again, do not put programs that you did not like higher in the list just because you think you might have a better chance there. You still have the same chance even if you rank it last.

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Match/Pre-Scramble Research - What Should I Focus On

Match/Pre-Scramble Research - What Should I Focus On (Part 1)
As we get near the match day anxiety builds up. Will I match? How competitive are the programs that I had interviews with? What should I do if I don’t match? Is there a way to prepare for the Scramble? If any of these questions rings a bell, you are not alone. Join the crowd of applicants that are anxiously waiting for the Match results. This feeling of uncertainty will be with you day and night. It will tickle you through the Super Bowl and Oscar awards up till March 15th, when you have the definitive answer in form of an e-mail from NRMP with the magic words, Congratulations, you matched or less pleasant, Sorry you did not match.

The goal of this letter is to help you control your anxiety by estimating your chances of matching as well as preparing you for the worst - The Scramble.

Estimating your chances of matching
The first and most important factor is how well your interviews went. This is your gut feeling and nothing else. So, try to think of positive and negative impressions you could have made.
o Did anybody from the program reply to your Thank You Letter?

o Did a PD send you a letter asking to rank them high?

o Did you manage to make personal connections with any of faculty/residents?

o Did anybody give you a hint on whether or not you were well perceived by the program?

o What is your overall impression? See our Who Is The Ranking Boss letter we sent earlier for ranking general criteria used by most programs (Academic Performance; Personal Statement; LORs; Compatibility with the Program; Compatibility with the patient population; Altruistic qualities/activities; Sensitivity to Social, Cultural, and Political issues; Communication skills; Commitment to the Specialty)



Second factor is the number of interviews. This is actually the number of positions you interviewed for. You should check quotas for the programs that you interviewed with. Program quota is usually equal to the number of PGY-1 class; however, it can be reduced by pre-matches. You can research if the programs you interviewed with did pre-matches last year by looking up the program at https://www.residencyplace.com/ProgramList.aspx?MODE=MB – look at the PreMatches column there. A good number would be 70-90 positions.
Third is the specialty (or specialties) of your interviews. Anesthesiology is more competitive than IM; IM is more competitive than FM, etc. The two most popular IMG specialties, IM and FM, typically require 7 and 4 good interviews respectively for a successful match. There is no way to come up with a magic number, so this is just a general estimate.
Fourth is competitiveness of individual programs you interviewed with. There is no way to assign a number to this factor, so just use your common sense.
o Program specialty is one of the most important factors determining competitiveness.

o University programs are typically more competitive than Community ones.

o Programs with a fellowship are more competitive.

o Programs in cities with a medical school are more competitive. Houston is a good example: 4 medical schools located in or around the city make all the programs hard to get to.

o Programs in a tri-state area (New York/New Jersey/Connecticut) are very competitive.

o Programs in large metropolitan areas are more competitive than in a small city.

o Programs that had unfilled spots in the past matches are less competitive. This is one of the few factors that can be measured objectively.

Most of the factors above are subjective and you are the only one who can assign a rank to them based on your own feelings.

A Disaster Plan
It will undoubtedly make you feel better if you did all the homework and know where you stand in terms of matching chances. You will get even more peace of mind if you are prepared for the unexpected - not matching.

Find out what programs are most likely to have open spots. Have these programs pre-selected in ERAS, so that you can apply to the ones that have open spots as soon as the Unfilled Positions List becomes available.
Gather all your documents, so that you have an application ready to be presented to the programs outside of ERAS via E-mail, Fax, or walk-in.
Set up your application for e-mail and fax delivery to the programs by means of friends’ help, fax service, or a Scramble service.
Know the programs in your city that had unfilled spots in the past and be ready to show up at their doors after you are done sending your application to the unfilled programs.
Research the Programs that Had Unfilled Spots in the Past
One of our sponsors provides a free Program Research tool at https://www.residencyplace.com/ProgramList.aspx?MODE=MB

Or you can follow this link, http://www.residencyplace.com/, and click on the Unfilled Positions link on the main page. If you are not registered, registration is free and does not require sharing your personal information. You will see a list, which you can sort by Specialty, Location, and, most importantly, by the Number of Positions. Here is an example of the top 10 programs that had open spots year after year:

* Identifier Program Name ST Prematch 2009 Prematch 2008 2009 2008 2007 2006 2005
IM 140-35-11-284 New York Methodist Hospital Program NY 18 18 19 9 9
SU 440-48-21-334 Baylor College of Medicine Program TX 14 8 6 1 2
SU 440-35-13-411 North Shore-Long Island Jewish Health System Program NY 12 8 4
IM 140-20-31-142 University of Louisville Program KY 2 2 11 3 1
SU 440-05-21-056 Los Angeles County-Harbor-UCLA Medical Center Program CA 10 12 11 13 12
FP 120-05-11-057 Arrowhead Regional Medical Center Program CA 1 4 9 2
SU 440-41-12-303 Allegheny General Hospital Program PA 9 3 1 1
SU 440-24-31-409 Beth Israel Deaconess Medical Center Program MA 9 9 10 7 4
SU 440-04-21-029 University of Arkansas for Medical Sciences Program AR 9 7 8 4 3
SU 440-05-21-031 University of California (Davis) Health System Program CA 9 6 7 8 7


You can click on each program to get more detailed information.

Gather Your Documents
You already have ERAS application, why bother? Unfortunately you cannot extract most of the information from ERAS for your own use. You cannot get the LORs, USMLE, and School Transcripts as well as the MSPE. What you can get is your CV/CAF and Personal Statements. You need to combine your documents in separate packages – one per specialty. Have the following documents ready to be sent to the programs:

Cover Letter to be sent as a first page of fax transmission or e-mail body
CAF or CV
Personal Statement
LORs
Medical School Transcript
MSPE
USMLE transcript or score sheets
ECFMG Certificate
Your Picture
Sounds easy, right? When you start getting them together, you realize that this is a lot of paper. Your application folder will contain 20-25 pages of various documents. Here are your options:

Have the pages handy and feed them to a fax machine as you send the faxes (does not really help with e-mails).
Scan them into a PDF file and use it as an attachment to the e-mails you send. You may use the same PDF file when faxing your application either directly from your computer or through a paid fax service. Most of them accept PDFs. The only negative side of PDFs is e-mailing. A PDF file will be quite large, which will slow down sending e-mails as well as cause some e-mails being blocked because of a large attachment or presence of an attachment.
Prepare your application as a web page, so that you can just e-mail links to the application web page with the E-mail Cover Letter. You can also print the page into PDF and use it for faxing.

Obviously the last option sounds most attractive. But how do you accomplish that? You are a doctor and not a web designer. Here comes our sponsor again. Residency Place provides a free web page design and hosting service. We wouldn't have mentioned this in our newsletter if it wasn’t free with no strings attached. After you import your ERAS CAF and upload or fax copies of your documents, you get a personal web page that looks like this: http://www.mydocstat.com/USERS/Sample/Index.html

Now you can use this link when anybody requests your application package.

Set up your application for e-mail and fax delivery


Ask your friends and relatives to help you in the Scramble day. The more people/computers you get the better. Make sure you provide some basic training on what they should do. Share copies of your application and links to application packages with them. Provide them with a copy of your cover letter. As soon as the list of unfilled positions becomes available, they should share the load with you. You can share it either by specialty or by geography: Joe is doing IM e-mails, Jane is doing FM e-mails, Bob is doing IM faxes, etc. Review one of the past years lists at https://www.residencyplace.com/ProgramList.aspx?MODE=MB and perform some test runs to make sure everybody knows what to do.
Subscribe for a fax service, which lets you fax your application electronically. Just do a Google search for “fax service” and you will see a lot of options. Make sure you do a test well before the Match, so that you know what the steps are and, most importantly, what your documents look like.
Subscribe to a professional service that does both e-mailing and faxing of the documents on your behalf. You still have to handle ERAS application, but this is a much smaller burden. You can use any of our sponsors depending on your needs: www.imgresidency.com and www.residencyplace.com . When you consider a service, make sure your application is not delivered in bulk, is individualized, and the unfilled positions list is cross-referenced with a pre-set program information, so if a program does not have e-mail or fax in the list, your application is delivered to the address on file.

Get your ERAS application ready
ERAS is the best way to deliver your application to the programs. Unfortunately there is a 30 application limit. This is a reasonable limit for a US graduate. However, it is too low for an IMG. This is why you still need e-mails and faxes.

You must optimize your ERAS application to make sure you do it as fast as possible. Select the programs that you found in the Past Years Unfilled Positions Lists, https://www.residencyplace.com/ProgramList.aspx?MODE=MB, a couple of days before the Match. This way, when this year’s Unfilled Positions List comes up, you already have them selected and the only thing left to do is check appropriate boxes for these programs and click Apply. This will take you only a couple of minutes and put you ahead of others who are cross referencing programs only after the list has come up.

Relax and enjoy your time off

Now, after you did everything you could, to prepare for the worst, you can afford to enjoy your time off. Enjoy the Super Bowl. If you do not care about the game, enjoy the commercials and the Half-Time Show. Enjoy the Oscars. Hopefully you won’t have time to do that in the nearest three years.


Good Luck!
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Plan of The Game

1. Have the following equipment available: two or even better, three phone lines, cell phones will do fax machine; computer with high speed internet connection a couple of friends who will help you to call the programs frozen lunches or a friend ready to bring some from the nearest McDonald's
2. Get the unmatched programs list
3. Call, e-mail and Fax your application as fast as you can, so you are ahead of others

What you should expect on that day
1. Monday from about 9 AM CST every future resident in the country is trying to log on to the NRMP. Needless to add - most of them are unsuccessful. The closer it gets to 11 AM, the less chances one has to get there. The web site just cannot handle the load. That's where having a fast internet connection, more than one computer and a couple of friends trying to log on, pays off big time.
2. After logging on, you still are three clicks away from downloading a list of unfilled programs. Each click you will have to repeat from 10 to 100 times because everybody else is doing that. What you will see is a "Site is unavailable" page after some time out. My advice - do not give up and start over, use browser "Refresh" to get thru.
3. After getting the list, you have to filter out the information you need: specialty and geographic location. Now you need to compile a list of phone numbers, e-mails and faxes of the programs you want to apply to.
4. You log on to ERAS and apply for 20-25 programs you are interested the most. Save 5 applications for the leads you are going to get from faxing and e-mailing.
5. One of your helpers faxes your application to ALL programs in ALL specialties you consider. I recommend using some fax service like http://jblast.jfax.com/ . You can pre-load your documents in advance. The most important thing - they have lots of phone lines and fax machines trying to deliver your faxes simultaneously. Their service is $.06 per page and it's worth it!
6. Another helper of yours e-mails your application to the programs.
7. You and all other helpers available call the programs.
8. You get a spot if everything went OK!

Everything listed above should be of some help for you just by itself. If you need professional help getting your information before or after the match to as many programs as possible, please see the "IMG Residency Match" and "Post Match Scramble" pages.

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A few years ago blogging took off and became very popular. Let's see if this will work for me.

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