28 January 2015

Med School Update: Match Rank Order List

Last year when we were beginning fourth year, I sent out a plea asking for someone to give me the DL on residency applications, interviews, and advice on how, in the world, the match actually works. I got nada in response. That's not true - I received blank stares and well wishes. That should count for something, right?

If you recall, in October Scott applied to ten residencies that he was most interested in, and throughout November and December he occasionally took breaks from his required rotations to interview with the residencies that invited him to visit.

When friends and family asked where we would be for residency next year, I've told them about Scott's list of ten residencies and interviews. Then I described how Scott would rank his list of residencies in order of his preference and the residencies themselves would rank all of the students they would accept into their residency in order of preference. These lists would separately be submitted via the internet. Then magic happens in March, and the computer algorithm would spit out where my husband would receive training for his future career. The National Resident Matching Program (NRMP) website shows pictures of ecstatic models and names this process "the algorithm of happiness." Really?! I think that's taking it a bit far, but whatever makes you feel good.

Now that Scott has officially submitted his rank order list for residencies on the NRMP site, I have a better understanding of what is going to happen during the match process in March. I've read several articles from residents and doctors about the process, but probably the most understandable explanation came from Scott's school in a PowerPoint slide sent to students.

In my words, aka layman's terms, here is a synopsis of the national resident matching program:
The first part I described above is still true. Each student will apply to and interview with residencies. In these interviews, the students and residencies (residents and faculty have a voice in the decision) have a chance to ask questions to form an idea of whether the residency would be a good fit for the student. Fit depends on the student applicant really - how they prefer to learn and work, what types of procedures they want to perform, if they feel a connection with faculty or current residents as future mentors and colleagues, focus of the residency training, the student's bedside manner and interviewing skills, etc.

Pretty much every interview will end in the student saying "I would love to come train with you next year," and each residency coordinator sending you a thank you card to say how much they enjoyed your visit and hope you stay in touch. It is important to stay in touch with the residencies you plan to include in your rank order list, which means email or call residents and faculty with questions you still have about the residency. The students are not allowed to tell the residents the order of their rank list, and the residencies are not to ask.

Students register for the match often before they've even interviewed. Then in February the rank order lists are due for the MD residency match. This is where the algorithm of happiness makes  difference.

This is how the algorithm works, as it was explained to me. The student will list the residencies they wish to match with, in order 1 - 20 (you can add more to the list for a fee) with one being your favorite residency. The student will want to list residencies that are their favorite but also consider the odds for the residency including the student's name on their rank list. So if the student didn't interview with a residency that they applied to, the odds of that residency including the student's name on the rank order list are slim. Something to keep in mind.

The residency then lists all of the students they would accept into their residency in order of their favorites (not sure if there is a limited number).

Between the February rank order list deadline and the match announcements at the end of March, the algorithm tries to put students into their first choice of residency. This happens if the residency has the student listed on their rank order list of students and if there is a resident position open. If the student wasn't on the residency's rank order list or other students also ranked it high and were listed higher on the rank order list, the algorithm would then move on to the students second choice and goes through a similar process. In theory, the algorithm is supposed to connect the most student applicants with their first choice of residency.

Clear as mud?

The long and the short of it, is that we'll announce in the end of March where Scott will be training for the next three years. Booyah!