Match ranking advice: Trust your gut

Timothy M. Smith
Senior Staff Writer
AMA Wire
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Matt Lecuyer, MD, is a pediatric emergency medicine fellow at Brown University. He has gone through Match twice and is thrilled with the results. But he knows how stressful it is, not because of the process of submitting a rank list, but because of the emotions and the churning thoughts leading up to Match Day. He has several pieces of advice for students about to go through Match ranking, which opens Jan. 15. The first is probably what most medical students would like to hear: Follow your heart.

Between the resources available at his medical school, University of Massachusetts, and those available from the National Resident Matching Program (NRMP), Dr. Lecuyer was confident he understood the Match ranking process—where to go to submit his rank list, when to do it. But he was less prepared for the stress of making his selections, waiting for the results, wondering if he would match and, if he did, where on his list he would end up.

“Fourth year of medical school is filled with stress,” Dr. Lecuyer said. “You take your [USMLE] Step 2, which is your clinical knowledge and clinical skills. That’s stressful. And when it’s time to apply for residency, everyone asks themselves, ‘How many programs do I apply to? Am I a competitive applicant?’

“Then you submit your application and you’re stressed out about interviewing. And you go on interviews and wonder, ‘Oh, did I say the right thing? Did I make the best first impression? Is this program going to want me as much as I want it?’ And then you get to the rank list, and you’re stressed out about that too.”

Managing one’s stress is essential to getting through Match in one piece, and Dr. Lecuyer said it begins with knowing your must-haves in a residency program.

“I had gotten a lot of advice from people in my subspecialty, as well as people who were not in my subspecialty, advisors, mentors, friends,” he said. “The piece of advice that was really useful was to think back on every interview you had and your interactions with the faculty, the residents, your co-interviewees, and think about yourself being in that environment and with that group of people.

“Residency is the most intense, the most terrifying and the most amazing experience of your life. You might be moving across time zones or even across the country. So you need to know you’re going to have a support system, and I think that’s especially important now with concerns about resident and fellow burnout. You need to really focus on your own wellness and make sure you can see yourself with those people, because you’ll be spending more time with them than you will with your own family.”

He acknowledged that there is lots of pressure on students to reach for big-name programs, but he insisted that those programs should be held to the same standard.

“Don’t rank a program because it’s the No. 1 program or because it has a great name,” he said. “At the end of the day, everyone in your subspecialty sits for the same board exam, and every accredited program has to go through the same set of regulations, so your education is 90 percent standardized. It’s that 10 percent that really is what is going to make or break your residency experience.

“Trust your gut, because you know yourself better than anybody else, and you’ll know if you’re going to be happy in a program.”

Dr. Lecuyer followed this advice and was matched for his residency with Lurie’s Children’s Hospital, in Chicago.

“I was ecstatic when I matched there because I remembered the people were wonderful,” he said. “It was a great experience—I loved it and hated it at the same time. It was stressful. It was scary. It was tiring. I was basically living at the hospital. That’s why it’s called a residency—you’re a resident of the hospital. But my co-residents and faculty were an incredible set of people. It was the most amazing three years of my life.”

Other things Dr. Lecuyer said to keep in mind:

Don’t rank programs you wouldn’t be excited to join. In other words, there’s no safety in a “safety” selection. “When you go through the match process, you’re signing a binding agreement, so do not rank any program where you absolutely cannot see yourself being. If you think you would be miserable there, it should not show up on your rank list.”

Enter your rank order sooner rather than later. “Don’t let it wait, because if the website crashes, then you’ll be going crazy the night it’s due.” This echoes advice from the NRMP.

Be prepared to be matched with any program on your rank list. For about two weeks after submitting your rank list, there’s very little stress, he said. “Then all of a sudden, you say to yourself, ‘Oh my gosh, I could be at program one, program two, program three, or I could be at the one dead last on my rank list.’ You start picturing yourself there and how different your life is going to be from where you are right now, and you’re either excited or filled with dread.

“What most people don’t consider is matching with a program somewhere in the middle of their list, and they open up their envelopes and they’re not prepared for what they find. So don’t get caught up in where on your rank list you match, especially if you like all the programs you listed.”

Make the most of Match week. “On the Monday of Match week, I got an email saying I matched. I knew that was coming. But I didn’t find out where I matched until later in the week. In the meantime, my mind went to a hundred different places as to where I was going to be, what I was going to do. I had trouble sleeping.

“You just need to let it go and appreciate that you’ve matched. Enjoy the ride, and try to distract yourself as much as you can that week, because it is probably one of the most stressful weeks of fourth year. Embrace it, and then celebrate with your friends on Match Day.”

More on Match

Check out other Wire posts for additional insights from residents and fellows. Follow #Match2017 on Twitter to see where other students matched and check out #MatchThrowback for pictures submitted by residents showing their Match Day celebrations. The NRMP will host a Twitter chat on Tuesday, Jan. 24, from 2 – 3 p.m. Eastern Standard Time. Join by using the #ROL2017 hashtag.

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Dec 06, 2017
Health information technology had a significant impact on medical education—at both the graduate and undergraduate levels—in 2017.