Tales from the Trail: Mind games in the Match

By Walter Wiggins

At the time of this writing, my wife and I are still in the process of finalizing our rank order lists (ROL) for the Main Residency Match. I’ve been done with interviews for a couple of weeks now, so I’ve had a fair amount of time to sort out my gut feelings about the programs I had the privilege of visiting, and, when my gut wasn’t talking, some of the more relevant details of the programs and their respective cities.
In certain forums and between some of my new friends from the trail, there are rumors that “you’re ranked to match (RTM)” and other such “love letters” from programs along with the never-ending debate as to how one should reach out to one’s favorite programs (e.g. Should I tell my #1 that I’m ranking them #1? Should I send a message to other programs in my top 5? If so, when? And what should I tell them? …That I’m ranking them highly?). These thoughts are certainly enough to add a great deal of stress to the already stressful process of designing one’s ROL.

I haven’t sent any letters of intent, because I’m having a hard time deciding between #1 and #2. At this point, I probably won’t, because it’s not even clear if telling a program that you’re ranking them #1 might constitute a match violation. (They’re very clear on what you can’t ask a program – and what a program is not allowed to ask you – but they’re very vague on what you can say to the program, and vice versa.) However, I have sent out a few follow-up letters of interest outlining specific reasons for my strong desire to match to a select few programs. One of the concerns I have with sending out letters of this type is whether they’ll have any effect, as it could be assumed that I sent similar letters out to several programs. Another concern is whether a letter of interest, or even intent, could have much of an effect on your standing in a program’s ROL. Yet another source of stress is whether I should expect to receive any response to or feedback from such a letter.

We have all heard about people getting RTM letters from some places, but we’ve also heard the horror stories about an individual who had received a letter that they interpreted as telling them they were RTM and then they ended up not matching or matching a lot lower on their ROL than they previously thought possible. Even still, we’ve heard rumors about programs that don’t send out any RTM letters or anything along those lines. And then there’s the lingering question as to whether it might be possible to alter your ROL if you were to receive an RTM letter from one of the programs near the top of your list. After all, we all want to place into a program where we feel wanted. And surely each program must want to match people that really want to be part of that program, right?

As you can hopefully tell from this post, there are plenty of things that can muddy the waters when it comes time to make your ROL. As the time draws near for me to submit my list, I want to encourage those that will follow to avoid getting too caught up in the mind games that are inherently part of the anxiety associated with the process. Rank the programs where you interview according to how you feel about each one. Don’t let any communications you receive from a program unduly influence your decisions.

Once you’ve figured out where you want to go, if you’re going to send a letter of interest or intent, make darn sure you know that’s what you want to do before you do it and then make it count. Personalize your letter, so that the recipient understands that the communication is not just some form letter you’re sending to everyone. And, for the love of your future career aspirations, do NOT under any circumstances tell more than one program that you’re ranking them #1. If you don’t think the program administrators will find out, think again; they almost certainly will. If you do think they’ll find out and just don’t care, then you probably have bigger issues.

Enough on that… Good luck to everyone going through the Match this year. I hope you don’t need it, but in case you do, we’ll be putting out a brief guide to the SOAP (formerly, the Scramble) sometime in the very near future.

If you have any questions, comments, or anecdotes to share, please feel free to do so in the comments section below.


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