Building Your Ideal Rank List

So the way this works is interested medical students. You know, they decide on their specialty, and then they start shopping around for residency programs, doing their research, and trying to decide what residency programs they might want to apply to. And then they fill out their applications for these programs. They may be invited to interview with these programs. And then all of the programs that they interview at, they are asked to rank in their rank list.

So, essentially, each applicant lists all the programs that they are interested in matching at and ranks them from 1 to however many they they interviewed at, and they're not required to list a program either. So if they interviewed somewhere and they weren't really feeling like it was a good match for them, they don't have to list that program at all on their match list, in which case they will not match there. And on the flip side, the programs are doing the same thing. So the programs are interviewing all these different interested medical students for their positions, And then they create a rank list on their side and rank all of the different applicants that they interviewed, and, essentially, then the computer does the magic behind the scenes and goes through an algorithm and matches up interested applicants with their programs. And I guess I never really thought that much about it when I was a medical student.

It was just like, this is the what we're doing. This is a match. This is why it happens. And now I'm a fellowship program director, and our fellowship actually doesn't have a match. But for the last few years, we've been using what we have been calling a common timeline.

So you interview all of your applicants during a certain period, and then you can start offering all of your positions on a certain day. And everybody can consider those offers for a certain amount of time, and then you can move on and offer to the next applicants if you have applicants declining. And now I totally get why why the match works. Because, essentially, what we're trying to do is, like, a manual match, and it's an incredible amount of work to keep track of, you know, which app where you are in your rank list, what offers you have out, how long those offers have been held, and those sorts of things. It's a lot of work to do when you try to do it manually.

So, I totally get why the the match is the way to go.

It it wasn't just me matching. It was both of us matching together. So we're essentially linked. So we had to find programs that we were both interested in and areas that we were, both interested in. For us, we decided that we thought we wanted to come back to the upper Midwest.

That was one of the things we really were interested in. And the other thing that played into our decision making is at the time we were at medical school at WashU in in Saint Louis, and they have great programs for both radiology and pathology. So we were pretty happy with what they had to offer there. So we would have been probably pretty happy had we ended up staying there and matching there in our programs. We knew the faculty there and we're happy.

So we were kind of looking for programs that would either offer something different or potentially get us back into the geographic area that we were most interested in. So those were kind of the factors that we really thought about. We ended up basically interviewing at all the programs in Wisconsin and Minnesota and not much else because we figured we felt pretty safe based on the conversations we had with our home programs at WashU. And and we're kind of interested though in in perhaps coming back a little bit closer to family. Those were the kind of things that played in.

We interviewed at all of those places and then ended up making our lists based on a lot of co decision making and what worked for both of us.

Were there certain things that you were able to pull online or other kinds of resources? Was this talking with mentors at your program as far as the strength? I'm just trying to get an idea for maybe the listeners of how to go about some of these kind of more nebulous aspects.

Those were different when you looked at different programs. The the way that they structured those sorts of rotations were different. The way that people structure their both their clinical and anatomic pathology training, can be a little bit different. I mean, I think everybody wants you to have the same skills at the end, but there are many different avenues to get there. And, hopefully, all roads lead to Rome.

But what appeals to you, how you learn, how much subspecialty training you wanted to do in in individual types of subspecialty, anatomic pathology versus more general surgical pathology, for example, Those sorts of things are variable among different programs, and how how clinical pathology rotations are scheduled and assessed, how you how they teach you those things and and how they assess you on that learning. That material is variable. So I think a lot of that stuff can be gleaned by looking at the web page. They usually talk about their curriculum and their structure of their curriculum. Of course, these things can change.

So always good if there are particular things that you're are really important to you personally that you discuss those with what during your interview to make sure that you have the most up to date information. Advice from mentors and pathologists is always good. However, I I think sometimes it's it's somebody's opinion, so you always have to take those sorts of things with a grain of salt. And unless somebody's trained at a program or spent significant amount of time there, how much do they really know? Maybe some of it's hearsay.

So you just wanna, again, see for yourself, ask your own questions, do your own research, and I think, you know, talk to the program leadership and the the trainees in the program. So I think that's where the interview portion really comes in huge, you know, talking to the actual trainees that are in the program, how what they see is the strengths of the program, any shortcomings they see, in the program. And then, again, with the faculty members talking through anything that's particularly important or meaningful to you or things you don't understand. So I'm talking through those so that you hopefully have a really good feel for what the program is like, what the place is like, how trainees are feeling about their own program. I think those are really important things to glean when you're in your interview.

So this is easy for me to say in retrospect. But I do think it might have been just to not sell myself short and maybe have expanded my search a little bit wider when I was looking at programs. Because you never know. You know? You might try something and go somewhere for an interview and absolutely love it.

So I think it's always a great idea to give programs a a chance if you think that they have unique characteristics or something else that you might find particularly interesting. I guess, easy to say in retrospect. I don't know how practical it was at the time, but maybe I wish I had looked a little broader.

I had to try to establish a network of pathologists and kind of build my community and work my way into the community and network. It was hard. It was a little scary. But I think that when you go out to interview places, again, you meet a whole bunch of residents who are gonna be essentially contemporary with you, once you're a practicing pathologist someday. And those people are gonna end up all over the country.

They're gonna end up in all different specialties of pathology, and it starts there. You know? And it starts with meeting program directors, meeting different faculty members. People do tend to remember you once you meet them and and they see your face and you have conversations about your life. It starts small, but it was it's definitely helpful, I think, to meet people and just have a even a brief conversation with them and get to know them a little bit.

I think it starts to open the door for more ease of of getting your network built once you're actually in your specialty.

However, it's always it never hurts to to get input from impartial reviewers, if you will, to run it by a a few people. I think people that you haven't established kind of mentorship relationship with are always great people to kind of run this by. And, yes, they may have suggestions about, oh, this person is really familiar with this program, or they trained there, or they know you know, they have a lot of contacts there. Just go talk to them, see what they think as you're finalizing your decision. But at the same time, you know, it's it's your rank list.

It's your personal decision. And so I think asking for advice is great, but kind of going with your gut to some degree and what you really feel is the most important to you is is also gonna be what's gonna solidify things in the end.

It costs you time, but it doesn't cost you, you know, any money to travel to an interview to check out the website, look at the cool features that might really speak to you that different programs have to offer. So I do think that first step of doing your research and really trying to be thoughtful about what programs you want to apply to and and thinking about why you want to apply to those programs is really helpful. And I don't think there's any substitute for putting that kind of time and thought and work in upfront, but don't sell yourself short again. So if you think, well, that program's just it's out of reach for me. Well, how do you know?

So, you know, read about it. Think about it. It doesn't ever hurt to apply. And give those programs a a chance to, you know, actually evaluate you, and you may end up with a match made in heaven. Who knows?

So I think that prework is really important in setting the stage for your preinterview. Work and research is really important. And then, yeah, your interview's great for networking. Really pay attention to how the trainees feel about their program, how the faculty see the program. Let them tell you about the strengths and weaknesses of the program as they see it because I think a lot of helpful information can come from that.

And then when it's time to make your list, you know, really do do some introspection and think about what factors are really gonna be most important to you, whether they be geographical, family, and program factors, and decide how those are all gonna play out into your rank list. And then wait for match day.