Rank Order Decisions

As a reminder, rank order lists are due to the National Matching Service (NMS) or "The Match" are due on Friday, March 8th and Match results will be released on Friday, March 22nd!

Deciding which program to rank can be even more agonizing than deciding where to apply.  Programs that looked good "on paper" may not be as impressive in person.  Alternatively, a program which wasn't initially the highest on your list of considerations may now have some big selling points after you have visited the site and met with staff .  You may be creating lists of "pros" and "cons" for each interview site and also weighing just how important each "pro" and "con" is to you.

Here are a few basic things to consider:
1. Let your rank order reflect your short-term and long-term goals but don't forget to consider what your training will be like in the interim.  After you finish your PGY1 residency, what do you want to do next?  If you perform well as a resident, you may have a PGY2 position or job offer at the site if positions are available.  You may be weighing objective factors such as opportunities at a site (training stucture and opportunities) against the intangible factors (organizational philosophy or how much you felt you "fit"at a site).  My recommendation is to ultimately go with the "gut instinct" because if you are self-motivated, you may be able to create some learning opportunities in your residency.  Just remember:

2. DO NOT base your ranking decisions on how much you think the site liked you. Remember, it is against ASHP residency matching rules for either the site or the candidate to overtly share rank order before the match.  Some places are better about playing "poker face" than others.  A few sites may more aggressively court candidates but the larger majority stay silent until Match Day.  Dr. Smith and I have many, many stories of candidates who didn't rank a site or prioritize them higher and then were very surprised / disappointed to learn later on how much the site wanted them.

3. Conversely, if you encountered some red flags during an interview, think about the context.  Were there extenuating circumstances on your interview day?  For instance, a local hospital had a Joint Commission survey during their major interview week so staff there were understandably pulled in many directions during that week.  Was the negative interaction with a specific person at the site or did you sense it was the overwhelming culture?  When I was interviewing for residencies, I was put off by the attitude of a current resident at the time.  I finally decided I liked the site as a whole and am so glad I matched at a site where the overwhelming majority of pharmacists were very positive and welcoming.  You do have to spent at least 40 hours a week at site so were these red flags a deal-breaker?  How much are you willing to risk not matching at any site if you decide not to rank an institution? 

Best of luck with a difficult decision!  Please keep Dr. Smith and I informed about your results so we can congratulate your success or strategize during the scramble.