Important Rank Order List Qs

[demspawn]

Hello to everyone. Here goes:

a. Let us assume that you want to rank 2 programs. One is top ten, giving
7 spots and the other is ... well definetely not top ten (more like ), giving
3 spots.
You rank the better one 1st and the other one 2nd.
1. Top ten prog w/ 7 spots
2. Not top ten w/ 3 spots

What happens if say the better program ranks you 7th and the other one ranks you 1st, 2nd or 3rd?
Does the matching process still exhaust all possibilites for your first choice before bumnping you down to your second, or do you find yourself matched at your second choice, because you were ranked higher than your 1st.

b. Let us assume you match at your second choice. how bad will it look if you decline the position?

c. Finally in a more subjective note: Would you sacrifice 1-2 more years doing research in an attempt to go into the top ten program eventually (with clinician/researcher as your ultimate goal), or would you just go into the less strong program anyway and do your best to achieve your goals through that??

Thank you for your thoughts and good luck with the match.
D

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[speyeder]

It doesn't seem like you have a very firm understanding of how the matching process works. You should read the examples provided on the NRMP and SF Match websites for further clarification.

Although the NRMP & SF Match are 2 separate matching systems, both employ an 'applicant-proposing' system, which means basically it doesn't matter how the programs rank you. The system will always try to get you in to the program highest on your rank list, provided you rank high enough on the program's list to be accepted.

As far as your question goes, if the better program ranked you 7th and there are 7 spots, you'd be guaranteed a spot right? So where's the conflict?

Also your concept of the match is a little distorted. Once you match, you are bound by an agreement to attend that program, provided you have fulfilled all the pre-requisites for acceptance, such as passing your boards, getting your MD, etc. You do not have the option of turning down an acceptance, short of some dire consequence like a severe illness. That's the whole point of the match: it is binding. Can you imagine how much chaos there would be if people decided to turn down acceptances just because they didn't get into their top programs? There would be vacancies all over. Finally it is understood that if you rank a program you would be willing to complete your residency there. If you would rather not match at all than go to that program, then don't rank them. I think it would be a little arrogant to turn down your 2nd choice just because you didn't match at your 1st choice.

Finally as to your question about doing 1-2 more years of research to get into a top 10 program, I think that would be a mistake. Given how competitive ophtho is, I think we all should feel lucky and grateful to be accepted at all. The idea that we can sort of pick and choose where we'd like to go probably doesn't apply to 95% of all ophtho applicants. In addition, there is no way any program can guarantee you a spot, regardless of how much research you do. At least not with 100% certainty. It would be a violation of the match if they did. Finally I got the impression, after speaking with a few program directors, that doing additional research only marginally helps your application, if at all.

 

[Gottschalk]

As speyeder stated, the match is a binding contract. However, the matchee can choose not to honor that contract (with likely penalties of course). If one decides not to honor the match and not enter the residency program matched in, the program has the right to prevent that individual from entering any ophthalmology residency thereafter.
That said, the residency does have the choice of either performing the above or letting the individual out of the contract with no stipulations. This decision is solely up to the program. In the past, even when a legitimate reason exists for an individual to not enter a residency, programs have been known to apply this rule anyway. There is no way of predicting how programs will react to this request.
So, the short of the long is that anyone can decide not to honor the match, but they run the risk of never entering the field of ophthalmology. My advice is to match into any program that will take you because being an ophthalmologist sure beats not being an ophthalmologist.
Good luck with the match!

 

[demspawn]

THank you all for your comments

 

[ttt0079]

In addition, there is no way any program can guarantee you a spot, regardless of how much research you do. At least not with 100% certainty. It would be a violation of the match if they did. Finally I got the impression, after speaking with a few program directors, that doing additional research only marginally helps your application, if at all.

Just to point out a few rare but real phenonmena that have occurred in the past - an unmatched applicant who is completing or has completed a PGY1 appointment can be "hired" into a PGY2 training program outside of the match shall a vacancy becomes available (e.g. a matched PGY2 decides to leave the program). This will, of course, depend on having a wide network and relatively strong credentials amongst the unmatched pool (kind of like a long-term scramble). There were also incidences where someone who matched categorically in medicine or surgery then changes their mind during or after PGY1 and were hired into ophtho residency programs. Lastly, I think the contract of the match is for the PGY2 year only, and is renewed for each subsequent year (by both parties) assuming satisfactory performance.

 

[demspawn]

Just to point out a few rare but real phenonmena that have occurred in the past - an unmatched applicant who is completing or has completed a PGY1 appointment can be "hired" into a PGY2 training program outside of the match shall a vacancy becomes available (e.g. a matched PGY2 decides to leave the program). This will, of course, depend on having a wide network and relatively strong credentials amongst the unmatched pool (kind of like a long-term scramble). There were also incidences where someone who matched categorically in medicine or surgery then changes their mind during or after PGY1 and were hired into ophtho residency programs. Lastly, I think the contract of the match is for the PGY2 year only, and is renewed for each subsequent year (by both parties) assuming satisfactory performance.

Broswing the SFMatch site, I stumbled upon the current vacancies link and found once more (Pittsburgh program filled recently a PGY-2 vacancy for a new position) a program with a PGY-2 position vacancy. It seems that there are possibilites for MDs that have concluded there PGY-1 to enter into such programs out of the match and out of the scramble. Although you say it is rare it seems to be happening almpost twice a year, which means 2 more shots to a residency position.

Again thanks for posting

 

[Gottschalk]

FYI--Anyone can match outside of the match if they are not a US senior. Only US seniors are bound to enter residencies through the match. This means that anyone that sat out a year can match into a program outside of the match even if that programs participates in the match that year. Also, that program is not penalized for matching outside of the match if that person is not a US senior.
There has been much debate on this subject in the past, and I'm not sure what the final ruling was. Any program can match an individual outside of the match--even a US senior. But, if they choose to match a US senior outside of the match, then the program is not allowed to participate in the match that year, and must match every candidate outside of the match. The debate was if only the residency couldn't participate in the match that year or the whole institution. Again, I'm not sure how this panned out.
Programs rarely do this though because it eliminates a lot of strong candidates and locks them in to choices.

Hope this helps.