Making that Rank Order List

I’m currently on my second (and last) vacation of intern year, and it is also the week that 4th year medical students across the country must submit and certify their Rank Order Lists (ROLs), ranking all of the programs where they interviewed… basically, choosing which programs will be a the top of their lists and which they will *hopefully* Match into next month. In just a few weeks, we find out who will get to replace us as interns next year! (But really, how on earth am I almost a senior resident?!)

Making our ROL last year was much more nerve-wracking than I ever anticipated. It’s a big decision to put all of those programs into a list and then submit that list into an algorithm that has the power to put you (and in my case, a family in tow) anywhere in the country for (potentially) years of your life.

I interviewed at far too many places: I was offered 24 interviews, planned on attending 20 (one was cancelled due to weather and then the program rescheduled me on a date I had an interview somewhere else, so I declined the rescheduled date), actually attended 19, and ranked 14. (My school’s leadership has us all believe we needed a ton of options if we wanted to successfully Match, even in “non-competitive” pediatrics.) Going into interview season, I thought that there would be a few standout programs and the rest would just be “meh”, so it would be easy. Not so. I could have seen myself being happy at just about any of the ones where I interviewed. My approach to every program was: I need my first job as a resident so I can become a badass general pediatrician. That is my top priority. And I think that I could achieve that goal pretty much anywhere. But the next priority was: Where will I be HAPPY? Because that is a completely separate entity. There were a few programs that I honestly thought, “I would be miserable there…..” but with all of the advice I received to “rank every program!”, I was hesitant to discard any of the programs. That being said, it was still much harder to make this ROL than I originally anticipated, so I needed some help with sifting through all of these programs. I did use the NRMP’s PRISM app to submit an initial ranking immediately after each interview, which set me up with a good idea of where they all fit into a list based on many factors, but it still felt a bit off.

I needed something more tactile, more visual. I wrote down every program I interviewed with onto a Post-It. All 19 of them. I then met with my med school advisor/best friend at a bookstore coffeehouse along with The Handsome and The Ladybug. At a tiny table, I took all of those Post-Its and went through them one by one, moving some higher or lower on the list. My advisor/best friend would give her input on the individual programs where she knew people, knew my interests, and knew my family and how they would all fit together. Her input helped immensely! It was nice to step back from the stress of the process to see the big picture. When we left the coffeeshop (An hour later? Two hours later?) I had a rough list and felt a little more reassured. There were still some programs that I wasn’t sure were in the right place on my list, or if I wanted them on the list at all (at that point, I had not yet discarded any of them).

So then, using those same Post-Its, I played a little game. I folded them all up, and over the course of several days, I would randomly draw one and open it…. pretending that was my envelope on Match Day. If I was excited, it stayed at (or moved to) the top of the list. If it made my heart pound and I wanted to cry….. I threw it away. Once I had played this game and drew all of the program names….. I knew my ROL, and I knew it was right for me (and my family). I submitted, certified, and never looked back. Based on the AAMC’s data for pediatrics, I knew there was a >95% chance that I would Match at one of my top 5 programs on my ROL…. and when I opened those 5 Post-It’s, I was very excited. I knew we’d be ok no matter what my envelope  said on Match Day.

I’m glad I don’t have to go through that again… at least until the fellowship Match in two years. 😉

To all of the MS4’s out there stressing over the ROL deadline TOMORROW…. it will all be ok. I can’t wait to see where everyone is headed! (But if you’re going into Peds…. my program is the best and I hope to see you this June!) 🙂

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