Exclusive Residency Insights From the Head of the NRMP

Ryan Syrek, MA


December 07, 2018

Medscape: What advice would you have for students who are just a few months away from their Match Day this coming March?

Signer: They should rank all of the programs where they would be willing to train. They should not rank programs where they are not willing to train because once they match, that is a binding commitment and they are obligated to accept the position to which they've matched. They also ought to include a mix of both highly competitive and less competitive programs within their preferred specialty. If they are applying to a competitive specialty—those tend to be the surgical specialties—they should consider a backup specialty, a safety specialty. They should be sure that when they complete their Electronic Residency Application Service (ERAS) application, they include all of their qualifications and not exaggerate. They should be honest in their qualifications.

Medscape: Students are inundated with information about residency, but is there something that they might not have considered?

Signer: I think they need to be realistic in assessing their own qualifications. That's why we publish Charting Outcomes in The Match. In fact, there is an interactive version up on our website that will allow applicants to input their own characteristics and learn whether applicants with those same characteristics have matched to that specialty in the past.

In cases where applicants don't match, it's usually due to a few things. Either they have overestimated their qualifications for the specialty to which they are applying or there is something in their background, either academic or personal, that makes program directors wary about placing them on a rank-order list. Examples are academic issues—either failure of a core clinical clerkship or failure of one of the licensure examinations. Those are the things that are most likely to result in an applicant not matching.

Medscape: Do you have any advice for first-year or second-year students?

Signer: They ought to look at the characteristics of applicants who have matched in that specialty in the past and think about whether they are going to meet that profile. For example, does that specialty typically match applicants with a lot of research experience or a lot of publications or a lot of volunteer experiences? They need to start working on those things in medical school. They might think about audition rotations at away institutions in the specialty of choice. Those are important. They should begin to develop appropriate mentors in medical school who will be able to guide them through the process of The Match and also be able to write strong letters of recommendation for them in their preferred specialty.


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