The great match decision

[Mrs. MD, Esq.]

How did you and your spouses decide on what was the best program for your family?

My fiance has been going back and forth/changing the order of his rank list, etc. Unfortunately, having only spent a couple of hours with each program, it's hard to figure out if a program truly is going to be a good fit. Ultimately, I'm sure most of the programs will work out fine, but I was wondering if there was anyway you gathered additional information or things that helped make your decisions?

Most of the places he is applying, I have been to (with a few exceptions -- ex. Charlotte, which we are visiting at the end of the month since it's one of his top choices), so I'm not overly concerned that I won't like the areas, but I do want to make sure the programs are going to be okay. Also, for those of you who live in/have been to Charlotte -- any must-sees while I'm there?

It's a hugely personal decision. For us we looked at how close the programs were to family. We looked at the length of the program, anything that was 6 years instead of 7 was a bit of a plus for us (one program that was 9 years was definitely out.) The fact that I would have to take another bar exam if we moved factored in a bit and we ranked some programs higher than others based on that fact. We really didn't think about the "prestige" of the programs, I figured he would get great training at any place he was happy to be working at. It was up to my husband to determine what type of vibe he got from each place and the residents/attendings etc. to make the decision of whether he would be happy at work. This was important to think about, he vetoed a place I would not have minded living because he said the residents appeared to be so miserable.

We thought about all the above issues but our deciding factor was whether or not we could be happy living in a place for 6-7 years and that's really up to y'all. I remember waking up at 2am the night we submitted his rank list and thinking "why the &#@* did we but Place X on there? I can't possible live there!!!!" Luckily that's not where we matched! We ended up in a place that we both love, I feel happy to be here everyday. We didn't rank a ton of programs because we really would have rather not matched than have matched in a place either of us would have been miserable. Probably not the most helpful advice but it's what worked for us! I am sure that other people made their decisions based on completely different factors. Good luck!

[GrayMatterWife]

How did you and your spouses decide on what was the best program for your family?

Since being employed was in the family's best interest, and given that he was matching into NSG, we decided on the standard of: whichever program would take him.

I'm not kidding.

Since being employed was in the family's best interest, and given that he was matching into NSG, we decided on the standard of: whichever program would take him.

What a great example of the different factors people utilize in deciding on their rank lists! GMW and I both had husbands matching into the same competitive specialty, and we ranked places in a very different manner. I think this just proves the point that it is a very difficult personal decision.

[Deebs]

We looked at so many factors, including:
-how employable I would be (I'm in health care also)
-how many "seniors" had jobs by November - our #1 rank was the only program where all seniors were employed WHERE THEY WANTED TO BE by November (I knew I wanted a lot of notice for moving onto "the job.")
-the program itself - DH wanted as much time as possible in the ICU, and also wanted a program that had flight as a component
-what resources the program put toward it's residents. DH's program had the attitude of, "if you feel deficient in a necessary procedure or skill, we will do whatever it takes to help you learn"
In the end, some also came down to feel and fit. It's not really something you can put on paper. We were lucky. We ended up at our #1. Keep in mind, there are many who end up much further down on their ROL, and many who scramble. I would say, if there is somewhere you absolutely can't go, or a program you guys really DON'T want (like you'd rather take a year off, do research or change specialties, and try again), don't rank that program. Even if it's last on your list, you may end up there.

[GrayMatterWife]

What a great example of the different factors people utilize in deciding on their rank lists! GMW and I both had husbands matching into the same competitive specialty, and we ranked places in a very different manner. I think this just proves the point that it is a very difficult personal decision.

To clarify: I was being somewhat tongue-in-cheek. We certainly thought through the way in which the rank list was prioritized. For the most part, that prioritizing was based on the caliber of the research and research opportunities at the programs. We wanted DH to match into the best academic opportunity that he could. But, to understand that prioritizing, you have to understand our personal situation. First, we weren't considering a city that either of us would have deemed wholly "un-liveable," so we didn't HAVE to cross any off. Second, we viewed what might be "shorter term considerations" (e.g., do we love the city, is it close to relatives, etc.) as less important to us as a couple and a family than the straight consideration of which program would afford DH the best opportunity. That was a personal decision, though, and you have to be honest with yourself--if those things matter to you as a couple, you really should consider them. Third, I planned to make a major shift in my professional track (which I did) to allow for me to cary the burden of most of the childrearing, financial stuff, household obligations, etc.--so that being in a city away from family would not be completely impossible. If, however, I'd wanted to stick with BigLawFirm life, we would have had to consider living closer to relatives who were willing to help out, or moving to a city where I could earn a large enough paycheck to cover major nannying and housekeeper expenses.

And, then, fourth: beggars can't be choosers. NSG is hard to match into, no matter your grades and research cred. All matchers are beggars. So we did not cross any programs off the list simply because the city or program was less than appealing. For any program we might have crossed off, we had to ask ourselves: would DH rather NOT be a NSG than to go to that program? The answer was always no, so we ranked all the programs where DH applied.

We were incredibly fortunate to have matched where DH did. It was not his first choice, but it turned out to be a great opportunity and we are really grateful for fate, chance, and providence.

[MDPhDWife]

For us the number 1 priority was for DH to match. Seeing as he is going into a competitive specialty, we applied a little more broadly than we would've preferred, but not to places we knew wouldn't be livable. When it came time to make the rank list, our priorities were more about the city (cost of living, school systems, climate, ease of getting DD back to our hometown to visit her dad, etc) & how happy our family would be there. The prestige/caliber of the program came after that. We also factored in if the program had the fellowship DH will be seeking to potentially avoid another move. But really all of that came 2nd to how good of a fit the city was for us as a family. This made ranking pretty easy for us.

Luck was on our side & we matched at our #1 last week!

Good luck to you guys!

And, then, fourth: beggars can't be choosers. NSG is hard to match into, no matter your grades and research cred. All matchers are beggars. So we did not cross any programs off the list simply because the city or program was less than appealing. For any program we might have crossed off, we had to ask ourselves: would DH rather NOT be a NSG than to go to that program? The answer was always no, so we ranked all the programs where DH applied.

This is my point exactly, we answered this question differently. It worked out for us as well but it goes to show you that it's a personal decision. That's all I was trying to say, sorry if it came across as anything other than that!

[Urowife]

For any program we might have crossed off, we had to ask ourselves: would DH rather NOT be a NSG than to go to that program? The answer was always no, so we ranked all the programs where DH applied.

This. (Except not NSG, but urology). DH ranked all 20 programs he interviewed at for this reason. He matched at #5, and it turned out just fine. As for how he ranked the rest, I think it came down to where he wanted to live (we were not married at the time) and also prestige of the program. Kinda a combination of the two, I think. I also think he ranked 5 year programs higher than 6 year programs.

Good luck! It's a tough decision!

[SuzySunshine]

And also being in NSG we actually didn't rank one program where DH applied/interviewed because he decided he would rather not match then go there.

We looked at locations and reputation more when we applied then when we ranked. DH accepted 13 interviews and we ranked 12 based on the program and whether we thought we could live there for 7 years. I wanted a family friendly location and I asked our top 2-3 choices for spouses in the program I could speak to. At the time my career was very flexible so it didn't come into play as much.

[NYCHoosier]

In addition to getting a feel for the programs at the interviews, DH also researched as best he could using reviews on websites like orthogate. Once out on the interview trail, he determined his priorities for a program were:
*operating experience
*strong support for academic requirements (in-training exam, projects)...while he's not interested in academics, he didn't want to be SOL when completing requirements
*camaraderie among residents
*reasonable adherence to the ACGME rules / reasonable call schedules
*Icing on the top = moonlighting opportunities

My preferences were city based:
*New York - where we lived; where my job was; where my college friends live; where there are a number of good law schools; where life is just fabulous
*Chicago - closer to our parents; where I knew I could get a job; where there are a couple good law schools
*Indianapolis - super close to our parents; where my high school bf lives; less than an hour from a decent law school
*Columbus - where there are lots of fashion jobs; where there is a decent law school

Between our preferences, there was 1 program that we both liked. Just 1. DH ranked it first. He matched at his #1. Whew. (I liked 1, 3, 5, 6, 7, 13, 16, and 19... was dreading matching at #2 or #4).
So far, so good thanks to the thought/research we put in. I got the job at the company I was hoping to get a job with and have been accepted to the law school in town. DH really enjoys his coworkers and is getting a lot of good experience.
I miss New York, but otherwise everything has gone as I had hoped/planned.

Good luck! It can be stressful. Just try to figure out what your priorities are, and do your best to research the programs (easier said than done, I know).

[GrayMatterWife]

This is my point exactly, we answered this question differently. It worked out for us as well but it goes to show you that it's a personal decision. That's all I was trying to say, sorry if it came across as anything other than that!

Oh, you didn't come across as anything other than genuine. I was the one who sounded a little flip. I've been a member on the site for almost five years, but I've been lower on the radar the past six months or so. Some of the more newbies might not be familiar with me or where I'm coming from or my general tone. I just wanted to make sure that I didn't sound like we didn't put ANY thought into it at all. Of course, we did. It is just that, because NSG is a particularly competitive match, we didn't have the luxury of being able to consider the extra add-ons, like whether the city is somewhere we'd actually want to be for a long period of time. Hopefully, when DH finished fellowship in June 2012 and we are job hunting, maybe we'll have a little more flexibility in options. Although, knowing my DH, who KNOWS where on earth we'll end up...

[DCJenn]

The military does things slightly differently but it doesn't matter what or how you rank your list because there's a level of back room politics that is indescribable. We knew two months before the match results were announced because the departmental secretary where he matched told him. I'm pretty sure the rank list had barely been submitted- those desicions were made based on which programs wanted which resident not which resident wanted which program.

Jenn

[diggitydot]

How did we decide? The official Spreadsheet From Hell.

DH started during his 1st year of med school by taking each of the 400+ residencies in his field and inputting their info/details into an Excel s/s. He then proceeded to delete some here and there as we learned more about each one. When we finally got down to 30-some programs on The List, he began scheduling audition rotations to check them out. Of the 3 audition rotations, he ended up removing 2 from his final rank list completely. (The people sucked.)

The whole thing was ridiculous, but likely the reason he's in such a great program. His best friend did the same thing in his specialty. We all used to get together for dinner and the guys would run off to play with their lists while we wives drank wine and the kids all played.

[Michele]

I didn't read all the responses, but he ranked programs based on his preference for training and location. I was along for the ride.....though his location preferences are based on the same criteria as mine usually. Overall, I have to reiterate that the match is a crap shoot. Only rank programs you will actually go to, and if you'd rather be a (insert specialist here) than not, rank everywhere. We matched at our #9 out of 12 in Ophtho and ended up liking the location that was lowest on our list (and he received excellent training with the best surgical numbers in the nation).