Welcome, everyone. Welcome to our fourth and final Road to Residency series. Hopefully you've learned a lot. And we have this one geared towards what will hopefully be important to you in this moment in time about making a rank list, what to look for in a program when you're going through interview process and creating your rank list, kind of the etiquette for letters of intent, for match and for asking about second looks. We have some great residents who are volunteering their time to give their feedback. So we want to make sure that they had an equal voice with our amazing attendings to give their thoughts. I wanted to allow the residents and the attendings to introduce themselves. If the residents that are going just please tell us your name, where you have matched and then one hobby or activity that you talked about during interviews that you think helped you match. So I see Raghav first. So Raghav, you want to go and pass the baton when you're done? Sure. My name is Raghav. I am a PGY3 at the Medical College of Wisconsin. We have Dr. Sautner here also representing. One fun fact that I... There is a solid work on feedback. There we go. All right. One interesting fact I think that was talked about a lot was that I'm really into eating and making all kinds of pizza. I think I put that in my hobby section and that came up a lot. There's a lot of questions about what's your favorite kind of pizza, all this kind of stuff. So I think that was a good talking point. Eric, why don't you go? Yeah. Hey everyone. I'm Eric Jones. I'm a PGY2 at Mount Sinai. I think one of the fun facts that kind of stood out surprisingly in my application was I like to fly drones and do like some drone videography. It's kind of like the thing I do on the side and nothing too crazy, I guess, but it came up a lot more in interviews than I thought. And I remember one program even told me like, oh, we'd love to have help like revamping our program website and get some new pictures up or something like that. So I think there's never anything that is too small and things do get brought up more than you might think. All right, Raza. Hi, I'm Raza. I'm a PGY2 at Kessler and JMS. When I did my interviews, I think my thing I was most passionate talking about was my undying love for the New Jersey Nets or Brooklyn Nets now and a lot of trash talk coming from a lot of program directors. All right, Mark. Hi everybody. I'm Mark Volker. I'm a fourth year resident at University of Minnesota applying sports right now. As I go through my fellowship interviews, I'm still talking about the same things I talked about during residency interviews, which are board games and fantasy books. So always just having a little bit of conversation starters in the background can be a little helpful too. Nice. That's fantastic. Dr. Sautter, do you want to introduce yourself? Hey everybody. Carly Sautter from Medical College of Wisconsin also. I have not been through interviews in a little while, but I think one thing that I love to talk about still when I do interviews, which is a pretty safe and always well-received topic is my pets because people love to talk about their fur babies and it is a fun thing and always gets a smile on someone's face to talk about their little, their pets, whatever they may be. Fantastic. And then Dr. Key. Hey everybody. It's good to be on. I see a lot of familiar faces. This is Sloan, who had a refusal of bedtime already tonight. So we're doing well on this end of this, on the side, but I really enjoy reading about your old hobbies, especially on the new platform where you all have had to get really creative with your titles when you give yourself a hobby because you have to almost label it as a position. And so I always think it's really funny when you have unique titles for yourself and your hobbies. And I like to talk about what inspires you during your interviews. It doesn't really even have to pertain to medicine, but to see you kind of light up over what you love, it's really fun to see and just kind of see your personality. Awesome. Dr. Theriot. Hi, I'm Maya Theriot. I'm from Drexel University College of Medicine. And yeah, it's been what, I'm a PGY 23, I think now. So it's a little hard to remember what you did for interviews, but I, when I was interviewing, used to love to read about little snippets that people talk about. And one of the fun ones I remember reading and asking and learning about was someone who actually liked to sing doo-wop. And now I think I'm like an expert on that because I read it up. I had no idea what that was. But for myself, I like surprising people, just generally not at medical interviews. But when I see people, it is to tell them, you know, I never went to college because I did med school in India. So I went straight from 12th grade into med school. So no four years of having good fun in college for me. Awesome. And then last but not least, it's Dr. Nikola, I don't want to mispronounce your last name. So you're gonna have to pronounce it so we all know properly for the future. Sure. I'm Dr. Drakulovic. I'm the residency program director at UT Health in Houston. I tell people all the time that the J sounds like a Y and C is CH. I agree with everyone's comments already, especially with Dr. Keys. The hobby section is like one of my favorite parts of the application. And we really get a lot of insight into who you are through there. And the best conversations come out of that, you know, whether it's like hip hop music or something cultural, or, you know, all the countries you've traveled to your favorite hiking trails, like, that rounds out the application for us. And we really get to understand who you are as a person. So thank you for making efforts to sneak those in there. All right. So let's get going with our questions. So the first question groups topic is about how to create a rank list. I'm just gonna leave it open. Attending and residents, please give us your feedback. Question one is, what is the best strategy to create a rank list to get the best possible match when considering the NRMP match algorithm? Okay, I'm so sorry. This is something we had our RFC meeting, like two weeks ago on Halloween. And I said that this is the one thing that I wanted to talk about. I'm very passionate about understanding the match algorithm, because I think that people don't understand how much it favors the applicant. What does that mean? So the match algorithm is based off of the stable marriage problem. It's a Nobel Prize winning formula that is based off the fact that you want to create the most ideal match based on two sets of preferences. I'm going to send out two videos, and I'm going to send out a tweet thread about it as well in the group chat. So basically, it's applicant proposing. So the applicants are favored because the match checks against your preferred rank while determining the overall match. So you can submit, say, for example, UT Houston is actually a program that I ranked really high. It was a dream program out of my great organization, right? If I was somebody who was saying that, man, this is a reach program for me, but I don't know if I'm going to be able to match there, should I just rank it a little bit lower and rank somewhere safer higher so I can get where I want? No, the match doesn't work that way. You can rank whichever program you want as high as you want. And based on the way that the matching works, the match looks at your rank list before considering what the program's preferences are. So you still have a shot, as long as you've been interviewed, as long as you can rank by program to match there. It doesn't disadvantage you by putting a dream program higher. And that's something that I've been trying to explain to people for a few years now. And I'll send out the two videos and the tweet thread now, but feel free to rank your dream programs as high as you want. You've worked very hard to get to this point. And if you've been interviewed, you are in the game. You have as equal a shot as anybody to match to your dream program. So really go for it. Don't try to hold back or try to game the system. The only people that do that are the ones that end up places that they don't want to, or end up being disappointed on matching when they open up their letters. So shoot your shot. So that's my rant that I've been thinking about for a whole day. I feel like that was very well said. Do we have anything to add, or do we say drop the mic and get to the next question? All right. Yeah, I don't really have much to add after that. Just make sure everyone knows you can add any questions, comments that you all have in the chat. At the end, we will try to answer some of those questions, but all of our amazing volunteers will be able to answer them in real time. And then we will have a printout of all the questions and the answers on the website as well, in case you're not able to keep up with the chat. All right. So question number two, what advice would you give students on how to create their mental checklist and how to weigh different aspects of a program? For example, the structure of the rotation, strengths of one specific aspect like prosthetics in comparison to others. And along with that, what do the current residents on the panel wish they had weighed more heavily when creating that rank list for themselves and how they felt like a program was a good or not so great fit for them? So this is a question I feel like a lot of students always ask me, and it's very hard to answer because it's so individual to everybody. Some people like myself, I just I take my notes, I do my things. But a lot of what my end up my overall rank list ends up being is a gut feeling on did I like that program? Did I fit well with that program? Did I feel like the culture was what I wanted versus not? I know other people who had a spreadsheet, weighted every individual aspect of it, location, how many residents there are, fellowships that they have, you know, everything from A to Z and weighted them all. And then whatever the score was at the end, they just made that their rank list. So it's really however you want to do it, right? You just have to figure out what works for you. One thing that I wish I had thought about, ultimately, you know, gut feeling was what I largely went with, and then conversations with other people. But one thing I didn't think about as much as I think I should have is what fellowships are available at that institution. Because that can open some doors for you down the road, if you decide you want to pursue one of those fellowships. But I'm gonna stop talking now. Okay, I can chime in. Um, I would 100% echo what Mark said. I honestly think gut is one of the probably top things, but that's not something you can put a number to. But I counsel people on that a lot. And I really strongly believe that, you know, I think honestly, I think it takes a little bit of personal soul searching. Because I think what's what in addition to gut, I think it's it's a matter of starting to really be before even sussing out like the different aspects of each program to kind of identify internally, what is the most important thing to you. If that's geography, that's going to really change things. If that's a fellowship, or a certain program that a place has, that's going to change things, if it's size or research or anything. So I think I think my best advice would be to do the that kind of personal deep dive soul search. Even even, you know, that's obviously in addition, those other things are important too. But making sort of an internal priority list, before charting things out in a more objective way, because the objective stuff only gets you kind of so far. So I would encourage you all to do the you know, that kind of internal prioritization. And and then those things will really fit. I think that actually, then once you go through that process, certain programs will start to float to the top naturally be once you do that. So that I think, works, at least as a starting point for people. I'll jump in real quick. I agree with everything that's been said already, you know, you have your importance, right, the things that you really need in a program, whether it's a certain type of procedure or fellowship that's available. But the biggie is that you write down your feelings directly after having the experience with the program, whether it's this moment, and you you get a taste of some of us, or you've jumped on some panel that we've had, or you have had your interview with us writing down the feeling that you had that day is very important, because you'll lose that over the next few months. And February is a long way away, right? And so you forget the things that you thought that day, and it all starts blending together when you get closer to time to rank. So writing down exactly how you felt at the end of the day, and the specifics that you remember, are really important. And then yeah, you can weigh all the other things too. But your gut instinct does have a lot to say with if you're feeling like a place is your place, even though you didn't see it in person. I was coming in to say exactly that, as well, because I just feel that I'm actually not a person who makes lists. But I think it's really, really important to write down those feelings, because feelings go away after a little time. Maybe tomorrow, day after when you've done something else, you don't feel the same. But when you go back and look at those specific words, maybe that you've written about a certain program, it brings those feelings back again in your mind. So it would be good when you make your final list to have those done, and then look at them again. One of the things I would add on, from a clinical academic perspective, independent of the importance of wellness, the diversity initiatives, all these other opportunities, is flexibility of the program to allow you to pursue the opportunities that you want to do. So just because something exists in a program does not mean that you will have an equal opportunity to do it. So one of the questions that you can ask residents is saying, I know Dr. So-and-so or this department exists, how many residents are able to go? Or does your program allow me to travel X, Y, and Z to do this medical mission trip, let's say that's important to you. So that flexibility to me is always, at least it was important to me. And I would look at that as well, especially if you wanna match in a program for geographic reasons and family reasons, you wanna let that program allow you to travel maybe for a month or two to a different program to do something that you find interesting. Once, you know, hopefully that makes sense. I think I'm rambling at this point. All right. Mind if I just chime in real quick, Dr. Fossey? Yeah, of course. Yeah, no, just a last point for the question of something, you know, that I maybe could have weighed more heavily when making my rank list. I remember one piece of advice I received was just really taking to heart, like where you're going to be and if that's gonna be close to, you know, support that you have, whether that's family, friends, sniffing another. I think it's pretty easy as medical students to get carried away with the whole process and, you know, think like, oh, I should rank the highest rank programs or I should really pay attention to like this specific aspect of a program. I think at the end of the day, like you open that envelope and you're being shipped off to wherever that is. And, you know, I'm really happy to be at Mount Sinai in New York, but my family's in California and that's a, you know, it's a new change for me. So yeah, like just remember that wherever you rank, like you could easily end up there and I'd say take it to heart that, you know, you want to have that support close by because residency is a different time than medical school. And I completely agree with everything I'm going to say. I want to add on to Dr. Kasi's point as well. When you have those like resident socials and whatnot, also, instead of just taking notes with all the programs and interviews, also take them when you chat with the residents. And those are the times you can really ask the things that are close to your heart, the things that you care about when you're going to be living in that city. So ask them all those questions and write down notes for that part as well. Because I found when I was looking back a lot of my notes, I took programs, I took like notes when I was interviewing with programs about kind of all of those things, but I didn't take notes with the residents. And then when I was kind of trying to remember back, it was very difficult. So not only when you're interviewing with programs, but also the residents, I think that's a highly valuable when you look back at things and you're creating a rank list. Awesome. All right, let's move on to our next question. This might be better for the attendings. So the students ask, how much do the class rank and let's say board scores matter when programs are creating a actual rank list of the candidates that they like? I'll try to tackle this one. I think that this is different for every residency program. And so you're not going to get a consensus from the PDs here, how much those metrics matter, because I think every program views those metrics differently. What I do think you ought to focus on as an applicant is if you are being interviewed, you've got a foot in the door. So you have to then presume that your academic qualifications are not a barrier to you matching there, right? A residency program isn't going to interview you if they're not interested in matching you. So if you're there for the interview, you've got a foot in the door. Try to put whatever your academic qualifications are behind you and try looking at the residency program from the perspective that Dr. Cossie and our resident panel have mentioned. Does it have the things that I need? Am I going to have access to what I want? Is it a place that I want to be? Could I see myself there in training and try to ask those questions during your interview so that you get the information you need and you're not having to circle back to the program coordinator all the time afterwards? I think I can just add something. One thing to keep in mind with that too is there's inevitably going to be discrepancies amongst programs. So it's going to ultimately, even if programs are looking at it, there's a little bit of apples to orange comparison just because not every school ranks their students. Not every school has a tiered system. Not every school offers honors. Some are pass fail, some do, right? So there's many ways of evaluating medical students. And so programs inherently will have to take a little bit, look at the whole picture, especially once you're kind of in the door because it's impossible to do kind of a head-to-head comparison just because of the innate differences between how different medical schools rank or evaluate students. So also to add, a couple of the programs that I've worked with would rank the students and they would take this ranking from schools and things like that. A very small percentage of weightage, whereas most of the other things had definitely a higher weightage. I mean, you still do or might get points for being the topper of the class or doing really well. So don't completely negate that. So don't feel bad. If that is your strong point that you bring to the interview, that will be looked at. That won't be completely not looked at once you're in the interview. I don't know. Just one final point. And I think I'm speaking to the opposite end of what Maya was talking about. I think there's a lot of push for more of a holistic review. So I think with that being said, I don't wanna say there's an anti-class rank or anti-board score feeling, but I think people are more willing to look beyond that. So if your score isn't great, the impression that I get from speaking to people is people are gonna say, well, okay, what's your score? People are gonna say, well, okay, what can we find that makes this person unique and interesting? Whereas maybe 10 years ago, it was like, ah, we're gonna throw out this application. They were lower class rank. So it's a different kind of philosophy. So it's gonna correct again in five years based upon how you all as students do as residents. But for now, I think we would much rather prefer well-rounded people than people that were purely the highest class rank. I'm speaking for myself, but also some impressions that I get. I was gonna say the same thing. When I read through every single application, we each have our way of going about doing that. But usually when I use those things that you all have pointed out, it's to add or subtract you from my list. And so I had an invite list two times the sizes it should be by the end of it. And so a lot of times I'm trying to find ways to separate candidates. But usually you get invited because I want to know the whole person that I've just read about. And a lot of times it's because you are well-rounded as everybody's just said, it's your whole application. So you really shouldn't focus on your number and any one stance. And like you said, it's gonna go away soon and we're all gonna have to figure it out anyway because we need you to be clinically and academically sound. And we'll find our ways to know that. And just as one final tidbit is when you come into interviews. In the olden days, I feel like if you had a high board score, you could say I'm going to match into any and every program I want to. So if you are doing really well academically, don't give yourself a false sense of confidence, really focusing on doing well in your interviews and showing how well-rounded you are and because it is interview season. So just don't talk about your academics, really start to plug in some of the great, well-rounded non-PMAR holistic things that you do. All right. The next section is about what to look for in a program. That was kind of the theme. So this is about wellness. So how can a candidate know if a program, a residency program is truly serious about their wellness initiatives, support for their residents and how can you carefully craft questions during the interview to be able to ask a personal question without revealing too much about your wellness needs? I can tackle this if no one else will or it's just itching to go first. But I've gotten this question a few times already in the past couple of years as the interest in this grows and programs are actually tackling it. But I get it with wellness and DE&I and everybody's checking their box and they're on the train saying, yeah, we're all about your wellness. But the real question to ask is, can you give me an example of one of your wellness initiatives or some event you held or another one that really gets the PD talking or thinking is what do you do to support a struggling resident or a resident that's had an issue or a life event that's required extra time away? Like how are you gonna tackle that? And they'll say just enough to let you know if it's a tense situation or if they easily are able to support the resident throughout whatever that situation may be. Yeah, I think if you ask, like it will be pretty evident if the program is serious about wellness and they have true examples or it's just kind of something they check the box on. Like I know for a fact, I do these like Mount Sinai open house, virtual house thing, meet and greets. And everyone asks us about wellness. Like we are legitimately excited to talk about it because we have this like new wellness champion and these sessions we have every week. And it honestly is like a really good time to debrief and kind of get our voice heard in the program. And so like, I look forward to telling medical students about it versus other programs that may be a little more of a muted response or something. So I think that you'll kind of just get a sense as you ask those questions. Just to speak from a personal experience for my program. So, I mean, as many people know, Kessler went through a very big loss last year in the residency program. And if you speak to the residents who were there at the time, and actually we had the one year anniversary this past week, there've been a lot of initiatives like that have been promoted within the program, but also the way that the program has responded, supported residents, continues to support residents and follow up with them afterwards. I think things like that, programs can very easily speak to, like I think it's been said, if it's actually there and if it's actually something that's present, they'll be happy to speak to and happy to talk to it. And they'll be able to give you specific details about it. So don't be afraid to ask about it, but it's something that comes across again in the culture of the program and how excited people are to be there, because if they feel supported, they're gonna feel happy to be training there. And as a second part of the question, if someone has a wellness request, whatever that might be, that is very important to them and plays a big role in ranking a program, how do they ask the question? Is it appropriate to ask it during the interview or should they wait until after the interview as they're creating their rank list and ask a very specific question to the program director or the associate program director? I would totally ask it in the interview. I mean, if it's that important to you, you need to know that information. And I think asking about it for something that's so personal and meaningful is not something to shy away from. And it'd probably be good to ask the same question to multiple people and see, do their answers jive or are the answers very disparate? If the answers are very disparate, that makes me think that they're probably not doing a good job of whatever it is you're looking for. And it'd probably be good to try to get some sense of that, not just from the faculty leadership, but also from the residents too, and maybe compare the residents from who are PGY-4s, compared to PGY-2s and see if they have different takes on it so you can get the info that you need. But I wouldn't shy away from something that's so important. Great. In the theme of asking questions- Did you RSVP? Yeah. Nope. With the theme of asking questions during interviews, for the program directors, or for any of the residents that are doing interviews, do you feel that the questions that are asked to you impress you or change your opinion of a resident? Or do you feel like it's there for the resident or there for the student, but not really important to the interview process? And if you had an impressive question, could you give us an example? I can maybe just say a couple of things about that. You know, one thing that always really positive and positively impresses me is when students come a little more prepared for the interview. You know, if a student has clearly looked at my work and asks questions specific to what I do, or has looked at some of the programs, it's surprising how many students actually don't do that, or how many resident candidates don't do that. And so when it's clear to me that someone has really taken the time to learn about the program, learn about what the people who are interviewing them do, and ask questions specific to that, that is really quite a positive impression on me, and I always remember that. It just shows a higher level of interest, especially when people are potentially interviewing at many, many programs, some of which they may not actually have a whole high level of interest in. Um, this probably everyone knows, if they, you know, don't not have questions, that's kind of usually a pretty negative thing in an interview scenario when students, when you, you know, are asked if they have any other questions and they say no. You know, I think it, you know, even if you've maybe heard an answer or asked it before, just as with the last question, like hearing kind of what different people's perspective is on the same thing can be super valuable. So it can be kind of a double positive to have a set of questions that are thoughtful that you ask of people, each person that you interview with. Those would be, I guess, you know, from my perspective, some of the things that can really leave a very positive feeling with me when I interview students. Okay, anyone else have thoughts? I thought Carly, that was fantastic. So we don't have much to add. Okay, everyone's nodding yes. Okay. If you get an opportunity to do a second look, which will be the first time that you're able to see a program, what are things that you should be looking out for different questions that you should be asking? What should be your approach to the second look? I think that, again, is really personal for each person, what they're looking at for the second look. So if you're trying to make a difference between, you know, two or three different programs that you were really impressed with, you would look at both the positive and the negative things that you would have probably noticed when you interviewed. And, you know, want to ask specific questions or want to look at those things a little more specifically than the overall. I would, my thought would be, just you're checking out the vibe, I know it's just kind of a generic term, but everyone's got a certain feel of what they like, whether it be suburbs, city and a certain type of city and the pulse of the city and a certain part of the country. And so I think, one, it could break down your preconceived misconceptions, like I grew up in Chicago. So, you know, living in Chicago all my life, people are going to tell you different things about Texas or California or wherever, and you go there and you, you know, I've traveled different places. I'm like, all my misconceptions were wrong. So one, it could break down any of your misconceptions. Two, you can check out the actual facilities and you can see if you don't like to have to walk long distances to go do consults or whatever it might be, you can see what the actual workflow is because my residents right now would tell you, oh, we've got to walk to the, all these different places when we're on consults. To me, it's not that far, but you as a student might say, this is brutal, I don't want to do this. There you go. And you can actually also see people's body language within the hospital and within the department. Because when we're doing one-on-one interviews, I might, you know, I'm on my best behavior, but as you're there, you can see how the residents are interacting with one another. You can see the whispers, if there's arguments going on, hopefully there'll be none. But you can also see how they deescalate situations. So there's a lot of those subtleties as well. And then the final piece is the city. You are going to be living there. So if you go to that, do that second look, research the city, figure out where you think you'd want to live, where people, the residents live, go check it out. Because you know, once again, Chicago, you might hear stories of horrible violence, which violence does exist in Chicago, but there's a variety of different areas of Chicago, knock on wood, that, you know, that are safe and where residents live and culturally amazing places. I feel like I'm just selling you Chicago and I'll stop doing that, but make it a point to check out all those things. And like everyone said, write down those notes when you're there. Any other thoughts, people? We're crushing all this stuff here. I would jump in and just say that, you know, don't go to the second look just to show your face, right? I think program directors understand that you don't have the bandwidth to attend every possible virtual event for every place you're interviewing with, you know, and I don't know that there's additional value in just showing up and not actively participating. So I think if you're going to participate in those types of second looks, you have to make sure that it's worth your while, right? Actually being there I don't think says or does a lot to improve your standing, at least in my eyes. Yeah, I would second that. So I completely agree that the second look really should be about you going to fill out a place and to see if you can find yourself there when you're there. I can go anywhere, any city, which I like to travel and pretend I'm a local anywhere, but I can go pretty much anywhere and be like, yeah, I can be here. This can be my spot. And then I've also been places where I'm like, no, this is not for me at all. And you get that pretty quickly. You know, hopefully programs are able to show that virtually as well, or we're trying to get better at it, but you'll know pretty quickly if something's for you or not. And you read the room and see if there's tension, you know, on a regular work day or whatever. But, you know, the NRMP stance is that we don't have second looks until our rank list is locked, right? We're not even supposed to weigh in your presence at a second look on our ranking of you. And it makes it difficult because there's not a big space and time for you to come and see a lot of places between those two moments, us ranking you and when ranking ends. But it's not supposed to have any weight for you to come and check out a place. So don't ever go, like he said, just to show your face again. It's more for you to understand a place that you might want to live for the next three or four years. All right, we'll move on to our third section. Thank you, everyone. This one's going to be about letters of intent. So those letters that emails, whatever it might be, where resident or where students are telling the program about you're my favorite program in the world. So do programs take letters of intent seriously? Or not? Let's start there. Yes. OK, but I will say asterisk. Is that, you know, because of recommendations from, you know, AAMC, AAP, NRMP, a lot of programs will not reply to you in order to stay completely neutral and avoid any appearance whatsoever that they are responding to you in a way that guarantees a potential outcome. Right. So, you know, if you feel like you sent that letter of intent and you got ghosted, you probably didn't. The program is just being super safe because they don't want to put their match or their program status in jeopardy. So if you don't hear back, don't take it personally, you know, send that letter of intent, you know, to your top program and call it a day. Don't worry about it after that. Yeah, they definitely matter. You know, I've had people go unmatched and wonder what happened in a particular rank list. And, you know, I'm sitting in the background saying I had never heard from you again. I didn't think you were interested in us. You are from the West Coast, right? And so it isn't really important to tell your top programs that you're still interested in to maintain that connection, maintain your connections with some of the residents you met along the way, because it goes a long way. But, yeah, I'll always try to answer you. It's just very vague. So it's never a committal thing. But, you know, I do try to thank you for your your words because I read every single one of them and I don't agree with, you know, all of the past informants that say don't reach out to programs, don't send them emails. You know, it's it's important for us to hear from you if you truly are interested. As a point of clarification for all the students. Is the etiquette to so I guess when we rephrase this, because I know how I feel about this, but students want to know, are you should you write to only your top one, your number one and say you are my number one or should they are they allowed to write to their top three and say you are one of my favorites or something along those lines? What is the etiquette? What is the language that they should use when making that distinction between the top and top three? You all have a game to play, right? And yes, I've had my heart broken by some along the way, but usually most most of them that I get are you're in the top of my list. Right. You know, people that I know are very set in stone. You are my number one. This is the place I want to be. I usually know those people through and through by that point anyway. But most of the time it is a your program is at the top of my list. It's one of my top programs. It's never really a complete you're my number one. Yeah, nothing's worse than getting your heart broken. So I can speak to Dr. Key on that one. You all do it to us too. You know, we have people that we really want and we think we're cute and it just sometimes doesn't happen. I mean, it happens to every program every year. Yeah. Someone sends an email and you know, like you're my top choice. And that program ranked that person to match and they did not match, right? And the reason why, you know, we say about being cautious about letters of intent is because the physiatry community is small and you don't wanna burn a bridge. You know, say you, you know, messaged a place like you're my top choice and then they ranked you high enough to match and you didn't match there. And then three years later, you need their pain fellowship. They're gonna remember that, right? So you have to be careful and you know, not overextend yourself or oversell yourself on the risk side there. With Austin's question, you know, he said, when do students typically send letters of intent? And I did see variation in the questions about sending an interest letter, but if you're wanting an interview and then the letter of intent closer to rank time. You know, a lot of interviews have gone out at this point and not a lot of movement happens on wait lists these days because people aren't giving up their spots. But you know, if you, and it's a little late now, but pass on to your next crew. If you have a letter of interest going to a program, you really wanna send that quickly, especially with, I think there was a question about couples matching. If you have that information to bring to a PD, you need to get that to the programs that you are very interested in very early. Because if one side of the couples match does not invite, then you're likely not to get the interview either. And then if you get an interview and you wait, you know, a few weeks to be like, oh, by the way, I have couples matching, say we didn't see it or somebody didn't see it on your application. We may not be able to get your significant other an interview. And that's kind of a wash because you're not gonna be able to rank us either, right? So it's really important to be able to tell programs quickly that you're interested in them if they haven't sent out their interview invites yet. And then with letters of intent, yes, closer rank is very important to let us know that you're still on board with us. This probably goes without saying, but if a program says don't write us letters, like whether that's intent or thank you, like don't do it. You're not winning points. Just if they say don't do it, don't do it. I feel like that comes up fairly frequently. So I'm sorry if that sounds a little condescending, but actually just don't, if they say don't. Going along, I think someone kind of mentioned this, I think it was Dr. Key in terms of the communication from interview to match, to the finalization of your own rank list. And I think the final email would have been like, hey, you're my top program, if that's appropriate. What is it kind of the communication that a student can do without being annoying that can demonstrate interest in the program? And I think Dr. Key would be able to answer that question. What can a student can do without being annoying that can demonstrate interest, but not just emailing to be like, hey, I heard DeMar DeRosa is gonna be traded from the Bulls, like how do you feel about that? Maybe some of the residents, what did you all do? You guys all matched, what did you all do to communicate in between? I showed up to the medical student fair. There's a few that had some later in the year, but even though I'd already interviewed in some of them, I'd already done an audition at, I showed up because I wanted to, again, get a second look at what the program was like, just in the way that the residents and the attendings were teaching students maybe who were M2s and 3s, but I just showed up. And actually one of the program directors was like, oh, you already interviewed with us, but you're still here at the school. So just showing up is good. I will say I kept in touch with the residents, like at every resident interview social, most residents I think will give their email or some form of communication. So take those down, be more than happy to send emails there, or ask any questions along the way. I definitely did that. I think it helped me create my rank list as far as like clarifying some questions and answers to different things. So that helped. Yeah, and I think like conferences like AAP, AAPNR are also a nice way to keep in touch with residents you've interviewed or met with along the way. Especially the AAPNR falls kind of in between the residency interview time. AAP kind of ends up being once your rank list is in. So AAPNR is definitely a good place. And I would assume that, you know, a program that you think is going to be your top one or two, you really had great conversations with people. So if there is something that you mutually talked about, like an interest and it comes up in pop culture, I just talked about sports. So if you're, you know, you're talking about football and something happens and it's timely, you can be like, hey, I just was thinking about your program. You're my favorite and blah, blah, blah, blah, blah. The bears are terrible. And, you know, but obviously in a good natured way, so I don't get offended. That always goes well. Cause then it brings back like, oh yeah, we did have that great conversation, conversational piece. I would, at least for me personally, I'm not as impressed when someone says, oh, I've published, you know, my hundredth article I'm like, that's great. You know, like, I'm so proud of you, but I don't, you know, personality wise, I'll probably get that, that might get lost. But that personal touch is always fun. Then I'm like, oh, that person's cool. Let's rank them high, you know? That's exactly what I was going to say. It can be so small, but it's something that you connected on, whether it's the residents or the faculty. I, which I think people that I know have already interviewed, but one of my questions is what's your walk-up song if you play baseball, you know, what's your hype song? And I've had people change their song mid season, right? They email me, but like, wait, I have a new song. I need to let you know this. I've had a conversation with residents about what the best pen is. And so the person went out and bought what I thought was the best pen and like, just email me a picture and be like, you're right, I do love this. You know, it's just something super small. Our program was having the UK UT game the upcoming weekend. And we were really just kind of bantering back and forth the entire interview. And somebody wrote us and was like, how's it going? Knowing that UT beat UK, you know, is everybody super sad because they were talking so much trash that day. And it just, it can be so small, but if you can just pick up little pieces and then throw them in every now and then, it just shows that you're still thinking about us and that, you know, we're still maybe a priority. The best pen of all time. See, everybody's got one. And this person did, they emailed me later and it just made me so happy because I'm a pen nerd. and nobody can respond because you're all telling us your opinions. Oh, you're muted. We're just rambling on thinking I was saying some great stuff, but we'll just restart. We're down to our last 10 minutes of our road to residency. We figured we'd end early. I wanted to leave the floor open to any final thoughts that we can give the candidates. And I didn't know if there was any good questions in the chat that we wanted to highlight because some people may have missed it. Were there any good questions that we want to at least highlight before we do our closing? I think we're, okay. So why don't we just do this? Final thoughts with everybody. And then we can let everyone go to bed because it's too late now. Raghav, any final thoughts for the candidates? I think final thoughts are number one to echo Raza's initial mic drop. I think that's first and foremost, the biggest thing. Then after that is really ask the questions that you want to ask, because if you're afraid to ask them and it's probably not a place that you want to be if you're afraid to ask a question, it's really an applicant-favoring process to figure out what you want and try to see what program is going to help you with that and then create your rank list based on that. Yeah, I know that I got, I texted actually a few of the students on this to ask if I sounded like a crazy person in the beginning, but I really meant it. Like, you've worked very hard to get here. Don't feel afraid to shoot your shot. I think all the program directors who have been here, we all apply, all of them applied at one point or another and all of them really tried to shoot for the best program that was for them. And it doesn't matter what you thought it was, what you're competitive with was going into the program or to the process, because once you interview, you have a shot. So really trust your gut and go try to get yourself where you want to be. Also, if anybody wants the paper explaining the MASH algorithm, feel free to DM me. I'll send over the link to you. Yeah, I think that's what I would echo too, is make sure you really think through it, use your gut, figure out what you want and put it in the order that you want. For me, it's always really helpful just to have a running rank list throughout the season. That rank list can change as you go, but it helps you just kind of keep track of where you're thinking as the season goes. And then you can always fine tune it as you go. So it helps me kind of put things into tiers as the season goes. So consider that as well. Yeah, I think one takeaway from today that I got is just that aspect of the personal touch and that really does go a long way. And so I would take that to heart. And honestly, if at the end of a resident social or anything and a resident kind of hands out their email or something like that, I wouldn't be afraid to email them and just say, oh, do you mind scheduling time for a phone call? Just a brief chat a little bit more about the program. Residents are always happy to talk about their program and it's always an okay thing to do to just hear more about the program from someone. So just keep that in mind, the personal touch. I will, as my last comment, I will reiterate what we've already said, but we get hundreds of applications and we interview 60 people and it's really, really difficult to pick those 60 people out of all of the very qualified applicants, right? And so if you're in the room, we already want to know you and know more about you. So you need to own that and be proud of it because it's really just about finding your place at that point and keep in contact. Just like everybody has said, I'm putting my email in the group chat just in case there are certain questions. I love to hear from people, even if we aren't your person, you're not interviewing with us. We're all in the same specialty for a reason and it's small, just like we've said. So it's really great to get to know you and help you along the trail as much as you need. And I'm only saying this because I guess we won't get to say this to students later on, but no matter where you end up being, like people have said it again and again, society is a small place. And if you really wanted to work with someone and you didn't get to work with that person during your residency, you have plenty of chances later on to get to know that person. You have plenty of chances later on to get that person as your mentor or advisor or whatever it is. So make the most of where you are at the end of the day. And collaborate, use each other, work across different programs. It's an amazing thing. Get to know the people on your interview trail. I'd love to agree with all of that. One thing that I had wanted to mention before, just anything you see online, I know there's like Reddit and Google and stuff. I would just use caution reading those. There's a lot of people with a lot of stuff to say. So just use a little bit of caution with that. And I think most programs and residents are gonna be as honest as they can with you. So that's probably your best source of information. But the other thing I would say is just try to be as excited as you can. This is like a really stressful and difficult time. Interviewing is so much and so overwhelming, but it is so, so exciting for you guys to be entering this phase of things and really starting to get to be a physiatrist. So try as much as you can to just still find the joy in the process because it's really, really exciting. And there's still a lot of hard work ahead, but it's just that it's such a positive and exciting step in the direction that you've been working so hard for. So, and we love to see that enthusiasm in you too. Yeah, I agree. And that's why we do this as program directors is because we love being a part of this, right? Like we love the mentorship. We love the camaraderie. We love seeing our field grow and helping it move forward, right? So that's why we do this in the first place. So the one thing I would say is like more of a practical thing about like submitting your rank list. When you submit your rank list, do not wait the night before or the night that it is due to submit it. You need to submit it early and lock it in and leave it. Right? And you will get up in the middle of the night to log in and make sure that it's still certified. And then as long as it stays certified, you log out and you leave it alone. What you should not do is like hours before the deadline, log in and change things. Do not do that. That is your limbic system, like generating fear and anxiety, trying to mess with your prefrontal cortex. Do not allow the limbic system to do that. Sorry, I'm a brain injury physician. I have to sneak it in. Same, same. So once you like certify it, leave it alone. Because the last thing that you want to do is log in a couple hours before the deadline and uncertify and move things and try to certify. And then it crashes because it happens every year. Do not let it crash on you. So set up your rank list, certify it, lock it down and leave it. Full disclosure though, I do check multiple times to make sure that we're still certified. So I am that anxious limbic person. I do it too. I do it too, but you know what? I don't change it, right? No, I don't change it. I double check it, but I don't change it. That's funny. Awesome. All right, we are at the end. My final thoughts to you is this is a long career, a long process, wherever you go, there's gonna be good days, there's gonna be bad days, and you don't even know what's gonna constitute in a good or bad day. Just get yourself, match some place, go with the flow. And in 10 years, you are going to think and laugh at all the things that you're stressing out about now, because you're gonna have new stresses and new problems in your current life. And you're just gonna be glad that you can ring up your phone, call an attending that you worked with for questions, call one of your co-residents who for me, my co-resident is the room right next door in my office. And we're like, what the hell is going on? But I'm glad it's my co-resident and she was my former chief. So we get to hang out together for now in perpetuity. So it's gonna be fun. You're gonna be fine. And your life is gonna be great no matter where you go. Just, you are in charge of your own destiny with that stuff. So anyways, this is my last road to residency. I think Dr. Ryberg is gonna be taking over for me next year. Amy, tell me if that's right or wrong. I believe. Yes, that's correct. Phenomenal job. And so thank you all. It's been fun. And thank you to Amy. Superstar is always for coordinating everything and getting everyone in one room at the same time. And then our panel and our residents have been amazing and our MSC, Med Student Council. You've been amazing with getting all the questions. So they crushed it this year as well. And good luck to everyone. And we shall see you at APMR or AAP or wherever the conferences take us. So see you all.

Road to Residency

residency application process

rank list

personal connections

genuine interest

communication etiquette

staying true to yourself

making connections

medical careers