Making a rank list is difficult. There are a lot of factors that I looked at with each program, trying to weigh good training against location against interpersonal connections against overall vibe. For me, there were a few criteria that buoyed up good programs and caused other programs to be nearer the bottom of the list.
Positives: The top programs on my list had all or most of these characteristics:
- solid training, good reputation
- academic institution
- mid-sized (3 of my top 5 have 8-9 residents/year)
- ready access to abortion training without stigma or obstruction
- fun residents, people I could see myself wanting to hang out with
- good location: either at home or in the Midwest, or in a Midwest-vibe kind of place
- diverse patients and considerable access to underserved populations
- politically liberal location. One can only struggle for so long against a sea of red...
Negatives: Programs at the bottom of my list tended to have the following characteristics:
- questionable reputation
- possible flaws in training - not enough Gyn cases, difficulty accessing subspecialties, unusual rotation schedules, problems in matching residents to fellowships or low boards pass rates
- smaller programs (4-5 residents/year)
- abortion training that was opt-in or that was difficult to access; or training that required extensive travel; or many rotations at Catholic hospitals where abortions, tubal ligations, birth control were not performed/administered
- weird residents, or people I didn't click with as well
- interviewers asked strange or offensive questions. This happened only a couple of times but it left a bit of a bad aftertaste that was hard to shake off, even if the rest of the interview went well
- community programs
- non-diverse patient populations (particularly if fairly affluent and privileged). I'm interested in public health, treated a bunch of suburbanites would be a dream practice but not necessarily that fulfilling
- location: either too suburban, or in a town that's too small; or in a place that I wasn't sure I would fit into
At the end of the day, though, I found a few things interesting: my top 3 were pretty set from my impressions during the interview trail, as were my bottom 3. The problem lay in the 7 remaining programs in the middle - each of which had some good things going for it and each of which had at least one serious flaw. I agonized for a long time about where to put the middle programs, when someone passed on a piece of advice they'd been given. It sounds simple, but when you put it to use it's quite profound:
"Don't get your first choice and be disappointed that you're not at your second choice. Don't get your fifth choice and be disappointed that you're not at your sixth."
Basically, after you make your list, picture yourself getting into each program (starting at the top) and see if there are any programs you wish you had put ahead of it instead. If there is, that program should move up in your ranking above whatever program you're on. This should be done down the whole list, too - because you want each spot to be the very best option out of the remaining choices. Keeping this advice in mind, I was able to sit down one Sunday morning and try to visualize my life at each place. I must have been in the right mood, because my middle ranks just fell into place. I put the list online and certified it ("what if you get hit by a bus! at least you'll still match" was the phrase that was most often used). This was in early February, and then for a while I put the list out of my mind. Occasionally I would peek at my list, which I kept on my phone, to check and see if it still felt right.
Yesterday, I logged into the Match website one more time. I double-checked the list, to make sure everything was in order. I double-checked that it was certified, which means it's ready to participate in the Match. And then I took a screenshot of the list with the green "certified" text at the top, just as insurance.
The rank lists close at 9pm ET tonight. Then the real waiting game begins.