"You're my number one!..."

What does at the top mean? Please explain ...

I told my top program that I am ranking them #1 for reasons 1, 2, 3, etc. The other programs in my top 5 got emails letting them know I planned on ranking them very very high on my rank list for reasons 1, 2, 3, etc.

Tibula -

That is what I have/will be doing.

My original question still stands - what does "at the top" mean? At the top sounds to me like #1 - and, we all know that there can only be one #1.

Pardon my ignorance as I haven't looked into this yet, but multiple people have told me that you are not allowed to tell a program specifically where you placed them on your ROL (ie. #1, #2, etc.). However, you are allowed to use vague statements such as "very high", etc. Does that sound familiar to anyone else?

Neither you or the program are allowed to ask each other where you plan to rank each other. However, you can freely tell each other where you plan to rank them.

I think I'm going to do something like this as well. The only program I'll give an actual number to is #1. I cant decide between my top two yet however...

Why don't y'all just stop playing games and let the process work it self out. Programs aren't stupid and if you tell some program anything other than "you're my number 1" it can really only hurt you. All this B.S. about second looks, thank you letters, phone calls, is ridiculous and just corrupts the process, that when played fairly, works very well.

Read this thread on SDN: . It's pretty clear that PD's play games much more than students and some even outright lie. Despite what orthogate seems to portray, many students don't match to their #1, therefore if you would be perfectly happy at your #2-4 and want to let them know that for reasons 1, 2, 3, etc, then I can't see how it can hurt you.

To edit that a little, I don't think its smart to outright tell a program they are your #2, because it could hurt you more than help. But telling a program you are ranking them very highly can't hurt you, but it also may not necessarily make your rise higher in their ranklist either. Its up to them how they want to use it.

Not a very cheery link, but good to think about.

The match data show that 50% of applicants get their top choice and that 80-90% match in their top 4, but that includes ALL applicants including those in other less-competitive specialties who may only rank 4 places TOTAL. I'd be willing to bet that we (ortho applicants) have a higher proportion of applicants matching to lower ranks simply because it's more competitive. Good stuff to seriously consider in the next month and a half, no matter what your Step 1 score and publication status are.

And where are you a resident?

Here is one program director's view on this topic. For all of the Shoulder and Elbow fellowships in the ASES match we instituted a "no communication" policy following the interviews to eliminate any direct communication with the faculty and the applicants so that all of the gamesmanship, "we like you, do you like us" nonsense, etc... would be eliminated. It has been a breath of fresh air and the AOSSM has adopted a similar policy for the sports medicine match.

The American Orthopaedic Association (AOA) has recently formed an organization for Orthopaedic Residency Directors called CORD and this topic of communication and post-interview "activity" is on the agenda for our national meeting this summer in Boston. There are many program directors who feel, like we do at Columbia, that this activity and behavior negatively impacts the process, puts undue pressure on the applicants, and really threatens the integrity of the match and what it is designed for.

So I cannot promise that it will be an easy process but I can tell you that there are many people in leadership roles around the country who are fed up with this and I am optimistic that we can take the positive experiences from the fellowship match process and translate it to the residency match.

Students have every right to investigate, analyze, and inquire before, during and after the process (querying alumni who are residents in programs, querying residents who you met during a sub-I or during the interviews, etc...) but what we're trying to eliminate is the phone call that goes something like this: "John, hi this is Program Director X from Program Y and I just wanted to let you know that we really, really, really enjoyed meeting you were wondering if you had any questions for us?" Awkward pregnant pause, "Thanks Program Director X, I really enjoyed meeting you as well". Program Director X, "How much did you enjoy meeting us?" You get the picture...

So my advice to all of you is that if you truly have a #1 choice and would like to have your mentors use your "one phone call" to let that program know that is well within the rules of the NRMP and the process is not compromised. All of the "you're in my top", "at the top", "I'm ranking you very highly" are all very well understood to mean that you're not ranking them #1 so I don't think they make any impact whatsoever.

If any of you have any comments, questions, or insights about this I'd be happy to entertain any questions either via Orthogate or privately at [url=mailto][email protected][/url].

Once again good luck to all of you! While the match isn't perfect I can tell you from our recent experience of not having a match for fellowships that you never want to have that experience, trust me!

wnl

I believe they've already instituted that rule of no post-interview contact for people applying to plastics.

By the way Dr. Levine, do you think having your mentor/chairman/etc make that "one call" will have an affect on how you're ranked at a program?

At least for AOSSM, there may be no applicant-to-program communication afterwards, but I've already learned there's a lot of Fellowship PD-to-My Residency PD/Letter Writers. That's another whole game into itself.

In reality they probably don't make that much of a difference. If your "body of work" has put you in position to be highly thought of at a program you'll already be ranked highly so the call probably won't change much. Conversely, if you weren't going to be ranked highly, a call from the Chair or PD will likely not bump you up their rank list significantly.

As to the fellowship discussion I brought it up as an example of the "no communication" between the faculty and the residents. However, you can all appreciate the tremendous differences between trying to secure a 1-year fellowship (i.e. true mentorship) vs a residency. Programs are going to advocate for their residents and fellowship directors want to try and make sure they get the "right fit" so there will likely be some level of communication at that level which people can certainly debate the pros and cons of course. Taking the resident out of that equation, however, has been universally supported by the residents from all the anonymous surveys we have performed.

Hope that further clarifies some of the issues - thx

wnl